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History of Dentistry 






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Copyright, 1909 


National Dental Association of the 
United States of America 

• • • 

• • • • 

• • • • 

• • 

• • • 

• • • •< 


The idea of writing a History of Dentistry first suggested itself to 
me ten years ago, when I was charged by the Organizing Committee of 
the Eleventh International Congress of Medicine with the reproduction 
and description of all the appliances of ancient dental prosthesis existing 
in the museums of Italy. 

The highly interesting researches in which I then became engaged 
in order to carry out worthily the important mission intrusted to me, 
awoke in me the desire to gain still further acquaintance with all that 
relates to dental art in the time of the ancients. I was thus urged on to 
ever fresh efforts, not only in the discovery of prosthetic appliances and 
other objects of ancient dentistry, but in the study, as well, of dental 
literature and of all the written matter that might throw light on dentistry 
in past ages. 

This subject has already occupied many before me, and each one has 
brought to it his contribution of greater or less value, some in the form 
of short pamphlets, others in that of larger works. 

The end I proposed to myself was to write a History of Dentistry 
which should be much more complete, more circumstantial, and more 
exact than those published hitherto, and which, instead of being, as are 
many of these works, simply a compilation, should represent, at least in 
part, the fruits of personal research and scrupulous examination of a 
vast number of works of various kinds containing elements utilizable 
for the purpose. 

The first part of my work, which I now offer to the public, comprises 
the remote origin of Dentistry and its development throughout the ages 
as far as the end of the eighteenth century. In a short time I hope to 
publish the second part of it, viz., the History of Dentistry during the 
last hundred years. 

I have carefully collected the greatest possible number of historical data, 
keeping in view the consideration that some facts, although of little value 
in themselves, may possess a certain importance for the student desirous 
of procuring historical information relating to some particular point of 
dental science. 

If this book should, as I hope it may, contribute to the diffusion of 
exact historical knowledge as to the origin and gradual development 
of dentistry, my labor will not have been lost, for it will have realized 
the object, a highly practical one, which has guided me in writing it. 





Dental Art among the Egyptians 19 

The Hebrews 32 

Dentistry among the Chinese ^4 

Customs Relating to the Teeth among Different Primitive Peoples . 42 

The Greeks 45 

Dental Art among the Etruscans 67 

The Romans .... 77 

PART 11. 

The Arabians . 121 

Thirteenth to Fifteenth Centuries ... 140 



Thb Sixtbbnih Century i6i 

The Seventeenth Century 218 

The Eighteenth Century .... ... 255 


Every dentist who has ever given any thought to the development of 
his profession must have realized the growing necessity for an accessible 
and authoritative history of the dental art. The early efforts in this 
direction by Duval, Fitch, Carabelli, Snell, Linderer, Harris, and others, 
followed in this country by the more recent essays of Ferine, Dexter, and 
Cigrand, are out of print and difficult to obtain. The Geschichte der Zahn- 
heilkundey by Geist-Jacobi, and Notice sur rHistoire de V Art DentairCy 
by Lemerle, have given to the practitioners of Germany and France 
valuable information which the English-speaking dentist has often sadly 

Realizing this situation, at the first meeting of the National Dental 
Association, the late Dr. R. Finley Hunt offered the resolution: "That 
a Committee of Three be appointed by the President to report at the 
next annual meeting a measure looking to the preparation of a/w// history 
of the Dental Profession.'' After a careful consideration of the subject, 
this committee reluctantly concluded that, "whereas a complete history 
of dentistry may some day be the result of the effort now being made, 
this Association must confine its first attempts to the history of dentistry 
in America.'' In a letter to the committee the late Dr. W. D. Miller said: 
" Of course, a universal history of dentistry would be very interesting and 
valuable, but its compilation would naturally cost an immense amount 
of labor." Aside from this, it did not seem possible that the data for 
a proper history of the early development of the dental art in Africa and 
Europe could be collected by an association working in America. 

After several years of what may have seemed a policy of masterly in- 
activity the unexpected happened, and the committee was able to report 
at the Buffalo meeting of the Association that Dr. Vincenzo Guerini, 
of Naples, Italy, had written a history of dentistry from the earliest 
times to the beginning of the nineteenth century, and that this work, 
translated into English and fully revised, had been generously placed 
in the hands of the committee for publication under the auspices of the 
National Dental Association, in token of the distinguished author's 
appreciation of American dental development. 

The Association, deeply sensible of this high compliment, and fully 
realizing this opportunity for accomplishing a purpose which had hitherto 


seemed impossible, gladly arranged for the publication of the book. 
After the delay incidental to the production of a work of this character, 
and the necessary subscribers being obtained, this exhaustive history 
of early dentistry, by the greatest authority on that subject in the world, 
is presented for the serious consideration of the thoughtful and studious 
members of the profession. 

Dr. Guerini has spent many years of his professional life and large 
amounts of money in collecting the material for this work. Our historical 
records are scattered through a vast literature, and much of it is of great 
antiquity, and it has never before been gathered together and arranged in 
such a consecutive, logical order. 

The importance and value of dental art and science as a humane 
service are well recognized, but we are so accustomed to view the question 
from the modern standpoint that we, generally speaking, overlook the 
immense work done by our predecessors reaching far back in unbroken 
line to the mists of antiquity. It was they who laid the foundations upon 
which modern dentistry has been built, and no man can peruse the 
record of their efforts as set forth in Dr. Guerini's book without developing 
a higher appreciation of their work and a keener realization of the worth 
and dignity of the calling which they in common with ourselves followed. 

It has been deemed wise to make a few amendments and commentaries, 
and when that has been done the amendment has in each case been in- 
serted as a foot-note and designated by the initials of the commentator. 

The supervision of the work while passing through the press and the 
correction of proofs have been entrusted to Dr. Edward C. Kirk, of the 
Committee; the index has been prepared by the chairman. 

Charles McManus, D.D.S., 

chairman of Committee on Hittory of Dentistry ^ 

National Dental dissociation , U. S. A, 





The first beginnings of dental art were undoubtedly the same as those 
of general medicine, for it is evident that in primitive times, when the 
healing art was still in its rudimentary stage, no divisions could have 
existed in it. 

Scientific medicine, whose most ancient representative is Hippocrates, 
was preceded for the course of many centuries by sacerdotal medicine and 
by popular medicine. 

Necessity, instinct, and even mere chance must have taught primitive 
man some simple curative practices, in the same manner that they taught 
him gradually to prepare his food and to satisfy the other wants of 
life. It was in this way that popular medicine, which is found without 
exception among all races and is perhaps as ancient as man himself, 
had its earliest beginning. 

As regards sacerdotal medicine, it was principally derived from the false 
ideas prevalent among primitive peoples about the causes of maladies. 
When, for example, an individual in full health was seized with sudden 
illness, no one could imagine, in those times of profound ignorance, 
that this happened in a natural manner; the fact was therefore attributed 
to a supernatural cause, that is, to his having been stricken by the wrath 
of some divinity. In this state of things it was believed to be absolutely 
necessary to propitiate the inimical or vengeful divinity, so that the 
patient might be restored to health. It was, therefore, very natural that 
the intervention of sacerdotal aid should be sought, that is, of the sup- 
posed intermediaries between human beings and the gods. The priests, 
on their side, were ready to occupy themselves with such cases, for 
their services were always well recompensed, and, added to this, if the 


patient recovered, the respect and veneration of the people for the sacer- 
dotal caste was considerably increased, whilst if he did not, this simply 
meant that he or his family was not worthy of receiving the desired 
pardon, or that, anyhow, the Divinity, for good reasons of his own, 
would not grant it. 

However, it being to the interest of the priests to obtain the greatest 
possible number of cures, they did not limit themselves merely to offering 
up prayers and sacrifices and to imposing on the patients the purifica- 
tion of themselves and other religious exercises; they also put into practice 
— always to the accompaniment of ritualistic words and ceremonies — 
the means of cure which their own experience and that of others sug- 
gested to them. The art of healing the sick was transmitted from 
generation to generation in the sacerdotal caste, acquiring an ever 
greater development and complexity in proportion to the making of 
new observations and fresh experiences. It is to be understood that 
in this manner the priests became more and more skilful in the treat- 
ment of disease; they were really the doctors of those times, albeit their 
curative practices were mixed up with an ample dose of imposture. 
This, at least in many cases, must have had, besides, the advantage of 
acting favorably on the patients by means of suggestion. 

We learn from Herodotus that the Babylonians used to carry the 
sick into the public squares; the passers-by were expected to make 
inquiries as to their illnesses, and if it so happened that they or any of 
their acquaintances had been similarly afflicted, to come to the aid 
of the patient by offering their advice and making known the means of 
treatment that had effected recovery, exhorting him, at the same time, 
to have recourse to them. 

This usage had without doubt its advantages, as it must have led, 
little by little, to the recognition of such remedies as were most effica- 
cious, among all those recommended, against the various maladies. 

Another custom that served to furnish useful elements for the develop- 
ment of the art of medicine was that of the votive tables, hung in the 
temples by patients after their recovery, in sign of gratitude for having 
received the invoked blessings. These tables contained a brief descrip- 
tion of the malady and of the treatment that had proved useful in dis- 
pelling it. If we reflect that dental affections are often of long duration 
and very tormenting, the thought naturally suggests itself that among 
the votive tables not a few must have referred to maladies of the teeth. 

The numberless cases recorded by votive tables afforded precious 
clinical material, which without doubt was utili'/ed in a great measure 
bv the priests in compiling the earliest medical writings, and, as we shall 
see later, Hippocrates himself stored up all the medical records existing 
in the celebrated temple of Cos. 





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Among the people of ancient times, the Egyptian nation was, without 
doubt, the one in which civilization first took its rise and had its earliest 
development. From the time of Menes, first King of Egypt (3892 B.C.), 
the inhabitants of the valley of the Nile were well advanced on the path 
of civilization, and under the fourth dynasty, dating from 3427 years 
before the Christian era, they had already attained a high degree of 

Medical art and science in every country have always progressed in 
proportion to the general civilization, for the treatment of disease is 
one of the first and most important manifestations of civilized life. It 
is therefore natural that the healing art should have flourished earlier in 
Egypt than elsewhere, that is, in the midst of the oldest civilized people. 

There, as in other countries, medicine was practised for some time 
only by the sacerdotal caste; but not all the members of this caste were 
doctors and priests at one and the same time; there was a special class 
among them, called "pastophori," whose mission it was to cure the sick. 

Our knowledge of medicine as practised among the Flgyptians of old 
is now no longer limited to the scanty notices handed down to us bv Greek 
and Roman writers. The researches made by students of Egyptian lore 
have placed original medical writings in our hands, now already partly 
interpreted, that permit us to form a sufficiently exact idea of the science 
of Medicine in ancient Egypt. 

These valuable documents, denominated papyri, from the material 
on which they are written, now exist in great numbers in the Berlin 
Museum, in the British Museum, and in those of Leyden, Turin, Paris, 
and other cities; but the most important of the papyri treating of medical 
subjects is certainly the papyrus of Ebers, in the library of the Leipzig 
University.* This very valuable papyrus — the most ancient of all known 
works on Medicine — is the best written of all the Egyptian medical 
papyri, and is also the best preserved and most voluminous. In size 
it is 30 centimeters high, 20 meters long, and the whole text is divided 
into 108 sections or pages, each one of about 20 to 22 lines. I he cele- 
brated Egyptian scholar. Prof. George Ebers, procured it, toward the 

* See Introduction to the German translation of the Kbers papyrus, by Heinrich Joachim, 
Berlin, 1890. 


beginning of the year 1873, from an inhabitant of Luxor, in Upper Egypt. 
He published a beautiful edition of it two years later in Leipzig; and 
in 1890 Dr. Heinrich Joachim published a German translation of the 
whole papyrus, with an introduction and explanatory notes. 

The Ebers papyrus is written in hieratic characters. We here repro- 
duce some passages of it, so as to give our readers an idea of the style of 

Lepsius and with him the greater part of Egyptologists are of opinion 
that the Ebers papyrus is not an original work at all, but simply a copy 
of medical writings of still earlier date, belonging to different epochs, 
and which were collected and reunited to form a kind of manual on 

Fig. I 


Part of Ebers' papyrus in Egyptian hieratic characters containing three dental prescriptions. 

From some indications existing in the papyrus itself, Ebers has been 
able to argue, with quasi certainty, that the papyrus was written toward 
the year 1550 B.C. But some parts of it have their origin in a far more 
remote epoch; they go back, that is, to thirty-seven centuries or more 
before the Christian era. In fact, at page ciii of the Ebers papyrus* 
one reads: 

" Beginning of the book about the treatment of the uxedu in all the 
members of a person, such as was found in a writing under the feet of 
the God Anubis, in the city of Letopolis; it was brought to His Majesty 
Usaphais, King of Upper and Lower Egypt." Now, as Joachim remarks, 
the Usaphais herein named was the fifth king of the first Egyptian 

* The Egyptians had three different kinds of writing: the hieroglyphic, the hieratic, and 
the demotic. The hieroglyphic style, which is the most ancient and is chiefly to be found 
on monuments and in religious texts, consists of figures representing every kind of object; 
the hieratic or sacerdotal style is an abbreviation of the hieroglyphic writing; the demotic or 
popular style, the least ancient, resulted from further abbreviations of the hieratic. 

* See page 185 of the German translation of Dr. Joachim. 


dynasty, and he reigned toward 3700 before the Christian era. Hence, 
it may be argued that some, at least, of the writings from which the 
Ebers papyrus was taken were composed in the very remote epoch to 
which we have just alluded, or perhaps still farther, for it is impossible 
to know whether the book, deposited by unknown hands at the foot of 
the statue of the God Anubis, had been written but a short time pre- 
vious or at a much earlier epoch. 

Fig. 2 

Part of Ebers' papyrus in Egyptian hieratic characters containing eleven dental prescripiions. 

Dental and gingival maladies are in no way neglected in the Ebers 
papyrus. At page 72, a remedy is prescribed "against the throbbing 
of the bennut blister in the teeth," then two other remedies "to cure the 
bennul blisters in the teeth and to strengthen the flesh (gum)." 

It is somewhat difficult to say what is meant by bennul blisters; 
but perhaps it means small, gingival abscesses of dental origin. The 
first of the above remedies — probably meant to calm the pricking or 
throbbing pain that, in such cases, often accompanies the dental malady 
— consisted of: 

"Seps-grains Part I 

Dough '■ I 

Honey . " 1 

Oil "I 

To be applied on the part as a plaster." 



The other two remedies, very likely intended for the cure of dental 
fistulae, were to be used as masticatories. The first consists of: 

"Fennel seeds Part 






The other was still more complicated and thus compounded: 


Dam-plant Part 






Aloe wood 





f > 

At page 89 of the papyrus^ we find two other remedies, having the 
same object, that is, "to cure the bennut blisters in the teeth and to 
strengthen the flesh." 

The first is compounded in this way: 


Cow's milk Part i 

Fresh dates 

Uah corn 

To be left stand and then to be masticated nine times." 



This is the second receipt: 




Green lead 




Fennel seeds 

Olive oil 


To be used like the preceding one. 



* See the German translation by Joachim, page 162. 
' A fruit resembling cherries. 


In this same page 89 many other remedies corresponding to various 
indications are prescribed. 

"To strengthen the teeth: 

Powder of the fruit of the dum-palm Part i 

Green lead " i 

Honey " i 

To be mixed and the teeth rubbed with it." 

The following is another remedy for the same purpose: 


"Powder of flint stones Part i 

Green lead " i 

Honey " i 

To be rubbed on the teeth." 

Next comes a remedy "to cure the growth of uxedu in the teeth," 
that is: 

"Dough Part 




Green lead " 

To be powdered, mixed, and applied on the teeth." 

The word uxedu recurs more than thirty-five times in the Ebers 
papyrus, in relation to aflPections of the most diflPerent parts of the body. 
By confronting all the passages of the papyrus in which one finds the 
word uxeduy Joachim deduces that it does not indicate any special dis- 
ease, but has the general signification of "a painful swelling." Accord- 
ing to Geist-Jacobi, by "growth of the uxedu in the teeth" may be 
understood an alveolar abscess and the consequent swelling of the sur- 
rounding parts. 

Another remedy is intended for "the cure of the tooth that gnaws 
unto the upper part of the flesh." 

The translator of the papyrus remarks that by the "upper part of 
the flesh" is to be understood the gum. The remedy would, therefore, 
correspond to the indication of curing a tooth "that gnaws or gives pain 
unto the gum." But as one sees, even putting it in these words, the 
meaning is anything but clear. Perhaps the destructive action of the 
carious process, reaching as far as the gum, is what is here meant to be 
alluded to. Meanwhile here is the receipt: 

"Cumin Part i 

Incense . . " i 

Onion " I 

To be reduced to a paste, and applied on the tooth." 


Besides the remedies already given, the two following are prescribed 
for strengthening the teeth : 

"Incense Part i 

Verdigris ** i 

Green lead " i 

Mix and apply on the tooth." 

The other is compounded of : 

"Water Part i 

Absinth " i 

To be used as above." 

We next find a formula, preceded by this very vague indication: 
"Chewing remedy for curing the teeth." 

"Amaa-plant Part i 

Sweet beer " i 

Sut-plant " I 

To be masticated and then spit on the ground." 

Another masticatory is intended to "strengthen and cure the teeth," 
and is compounded thus: 

"Saffron Part i 

Duat-plant " i 

Sweet beer " i 

To be masticated and then spit on the ground." 

Finally, we have a medicament "for curing the gnawing of the blood 
in the tooth." It is complicated enough, being compounded with: 

"The fruit of the gebu Part^^^ 

Onion " Ti 

Cake "j\ 

Dough ** \ 

Anest-plant " 1J T 

Water " ^ 

One leaves it to stand and then chews for four days. 


But what meaning is to be attributed to the "gnawing of the blood 
in the tooth ?" 

It is almost certain that this figurative expression referred to the pain 
deriving from caries and pulpitis. It may have had its origin in the 
observation of two phenomena, that is, first of all, the pulsating character 


which the pain alluded to often assumes, and the eventual issuing of blood 
from the cavity of a tooth affected by caries and pulpitis, when the pulp 
is exposed. At any rate, the Egyptian doctors of remotest antiquity 
undoubtedly did not ignore the presence of blood in the interior of the 

From what we have related, it clearly appears that at that remote 
epoch many remedies were already in use for combating dental affec- 
tions. These must consequently have been frequent enough, which 
demonstrates the erroneousness of the opinion held by some, who affirm, 
as does Mummery,* that in ancient times diseases of the teeth were 
extremely rare. 

Besides this, it is fully evident, from the Ebers papyrus, that at the time 
in which this was written, dental pathology and therapy were still in a 
very primitive condition, and formed a part of general medicine, from 
which they showed as yet no tendency to separate; so true is this, that 
the remedies intended for the treatment of the teeth do not constitute a 
special section of the work, but are to be found among medicaments of 
an altogether different nature. Thus, at page Ixxii of the papyrus^ we 
find, first, three remedies against the itch; then five remedies for the cure of 
pustules in various parts of the body; next an ointment and a potion for 
the bennut blisters in whatever part of the body they may occur; after this, 
three medicaments against the bennut blisters of the teeth; and lastly, 
a plaster for curing crusts and itching in whatsoever part of the body. 

One finds no mention of dental surgery in the Ebers papyrus. No 
conclusions could be drawn from this fact if the work only spoke of 
medical treatment, for then it might reasonably be supposed that the 
compiler had purposely occupied himself with this subject only; but, 
on the contrary, the Ebers papyrus frequently makes mention of opera- 
tive interventions, and among these, of the use of the knife and of the red- 
hot iron for the treatment of abscesses and of certain tumors. Therefore, 
there being no mention made in the papyrus of any dental operation, not 
even of extraction, gives us reason to suspect that at that remote epoch 
no surgical operation was carried out on the teeth, and that, as yet, no 
instruments existed for practising extraction. 

In the time of the celebrated historian Herodotus, of Halicarnassus, 
who lived in the fifth century previous to the Christian era (about from 
500 to 424 B.C.), that is, more than a thousand years after the time in 
which the Ebers papyrus was written, the dental art in Egypt had made 
remarkable progress, and was exercised by specialists. In fact, in the 

* On the Relations of the Human Teeth to those of the Lower Animals, by John R. 
Mummery. Trans. Odontological Society of Great Britain, May, i860. 
' See German translation by Joachim, p. 120, 


second book of Herodotus we find the following passage: "The exer- 
cise of medicine is regulated and divided amongst the Egyptians in 
such a manner that special doctors are deputed to the curing of every 
kind of infirmity; and no doctor would ever lend himself to the treatment 
of diflPerent maladies. Thus, Egypt is quite full of doctors: those for the 
eyes; those for the head; some for the teeth; others for the belly; or for 
occult maladies."^ 

Having here had occasion to refer to the History of Herodotus, we 
will quote two passages of this famous work, which have a certain interest 
for our subject; 

"Whilst the tyrant Hippias, after having been driven out of Athens 
(510 B.C.), was marching against Greece at the head of the Persian army 
and had already arrived at Marathon, he happened one day to sneeze 
and to cough in a more vehement manner than usual; and he being 
already an old man, and his teeth all shaking, a violent fit of coughing 
suddenly drove one of them out of his mouth, and it having fallen into 
the dust, Hippias set to work, with great diligence, to search for it; but 
the tooth not coming to light, he drew a long sigh, and then said, turning 
to those who were standing by: 'This land is not ours, neither shall we 
ever be able to have it in our power; what clings to my tooth is all of it 
that will ever belong to me.' "^ 

In another part of the Historyy that is, in the ninth book, Herodotus 
recounts as follows: 

"When the corpses buried after the battle of Platea were already 
despoiled of their flesh, a curious fact was seen; for the people of Platea 
having collected the bones of those who had perished, there was found 
amongst them a skull altogether devoid of commissures, and composed of 
one single bone. A jaw was also found, the teeth of which, comprising 
the molars, appeared to be made all of one piece, as though composed of 
a single bone." 

Relative to this last passage of Herodotus, we may remark, as does 
Stark, that the total synostosis of the skull bones is certainly very rare, 
but that, nevertheless, one has authentic examples of the same, not only 
in ancient but also in relatively modern times, witness the famous skull 
of Albrecht von Brandenburg, surnamed the German Achilles, who 
died in i486, and was buried in the monastery of Heilbronn. As to 
teeth united together and forming a single piece, no example exists save 
in very ancient authors, for instance, in Valerius Maximus, who recounts 
a similar marvellous fact of Prusia, King of Bithynia, and in Plutarch, 
who attests to a similar fact in the person of Pyrrhus, King of Epirus. 

' Herodoti Halicamassei historia, 1570 fol. Euterpe, page 53. 
' Herodoti Halicamassei historia, lib. vi. 


It is very difficult to establish within what limits the activity of the 
dentists alluded to by Herodotus was displayed. It has been affirmed 
by some that dental art in ancient Egypt was very far advanced, and 
that not only the application of artificial teeth, and even of pivot teeth, 
but also stoppings, were practised by the Egyptian dentists of those 
days. Here are some data on this subject: 

Joseph Linderer^ tells us that, according to Belzoni* and others, arti- 
ficial teeth made of wood and very roughly fashioned have been found 
in Egyptian sarcophagi. 

George H. Ferine, a dentist of New York, in an article on the history 
of dentistry,' says: "Both filled and artificial teeth have been found in 
the mouths of mummies, the cavities in the former stopped with gold and 
in some cases with gilded wood. Whether these fillings were inserted 
during life for the purpose of preserving the teeth, or after death for orna- 
mentation, it is, of course, impossible to say. That the Egyptians were 
exceedingly fond of embellishing their persons with gold ornaments and 
bright colored materials is a fact which has been clearly established, 
and the discovery of mummies — of exalted personages no doubt — some 
organs of which were gilded and embellished with showy colors proves 
that their fondness for display accompanied them even to the grave." 
To this may be added, that after an embalmment of the highest class* 
it was usual to gild the eyebrows, the point of the nose, the lips, and the 
teeth of the corpse, and place a gold coin between the teeth, or cover over 
the tongue with a thin gold plate. 

Dr. J. G. Van Marter, a dentist in Rome, in an article on prehistoric 
dentistry,* writes, among other things, that the renowned archeologist^ 
Mr, ForbeSy had seen mummies* teeth stopped with gold. 

The great defect of all the assertions referred to is that of not being 
accompanied by any element of proof, wherewith to demonstrate their 
truth. When, for example, we are told that Mr. Purland possesses, in 

^ Die Zahnheilkunde, Erlangen, 1851, p. 348. 

' G. B. Belzoni (1778 to 1823), ^ celebrated Italian traveller and archeologist, visited 
Egypt and Nubia, and wrote, in English, a report on his discoveries, which was published 
in 1 82 1. We have not been able to procure this book; we have, however, read the Italian 
version, published in Naples in 1831, without coming across any mention of artificial teeth 
found in Egyptian sarcophagi. Therefore, unless the work has undergone some mutilation 
in the Italian translation, we do not know whence Joseph Linderer can have taken the 
above notice. 

* New England Journal of Dentistry, 1883, vol. ii, p. 162. 

* According to Herodotus and Diodorus, there were three different modes of embalming in 
use among the Egyptians; the most expensive of these cost one talent (about 5600 francs), 
the second in order 20 minae (about 1900 francs), while for the less wealthy there was a 
third class, at a much more economical rate. 

* See Giomale di Corrispondenza pei Dentisti, October, 1885, p. 227. 


\m collection of antiquities, a tooth pivoted on to the root of a mummy's 
tooth, the question suggests itself naturally: If this tooth is, as it appears, 
separated from the jaw of the mummy to which it is said to have belonged, 
how can we he certain that the tooth itself is really that of a mummy? 
Until sufficient proof of this be furnished, we cannot but consider the 
above assertion as absolutely without value/ 

The same may be said as to the assertions of Wilkinson and Forbes 
with regard to mummies* teeth stopped with gold. Where and by whom 
were these mummies found ? And where are they preserved ? Was 
the stopping, too, verified at the time of the finding of the mummy, in 
such a manner as to exclude all possibility of fraud, or was it discovered 
afterward, in circumstances such as to suggest the possibility of a misti- 
fication? It has, in fact, been reported' that the pretended Egyptian 
stopping in a mummy existing in an Knglish museum was nothing else 
than a practical joke, carried out, besides, in a very awkward manner. 

In opposition to the above assertions, we have the most absolute con- 
tradictory statements on the part of the most competent authorities. 

The celebrated Kgj'ptologist, Prof, George Kbers, has only been able, 
in spite of the most accurate research, to arrive at completely negative 
results in all that has reference to the dental art of the ancient Egyptians.' 

* I Thr olt-quotcd «ttttrmrnts of Mr. l\irland with rcrercnce to Egyptian dental art are 
rrwrdrd in the trtinsuctionii of the first monthU* meeting of the College of Dentists, an 
extinct Kn^liKh dcnttil usHocintion, and published in the j^uarterly Journal of Dental 
ScirniT, 1857% vol. i, p. 40, where the following note by the secretary' appears: "Mr. 
Purbnd repudiated the idea of the Chinese having been the first to manufacture teeth, and 
referred tt» numerous s|>ecimens in the British Museum, manufactured between four thousand 
and iwt^ thousand years ago by the Kg>'ptians, who he considered were the original makers. 
On the subjeci of fiini, Mr. Purland said he had discovered pieces of wood in the centre, 
and remarkeii u|H>n the aitificial teeth he had found in mummies.** 

Again, at |>age 6< of the same journal, in an article entitled ** Dental Memoranda,** by 
'l\ IHirland, l>eniisf, l*h.D., the author says: 

** ReliK>ni and others disa>vereil rudely manufactureiJ teeth in the sarcophagi of the 
t^vptians. .As regar\ls the use of gold leaf. Sir C»ardner Wilkinson observes, as a singular 
fact, that the K^vi^tians st\>p|MHl teeth with gi^ld. 

** It is true that rudely manufacturer! teeth have been t\)und in the heads of Kg>-ptian 
mummies, but it is e\)ually true that teeth of a NTr>* superku make and adaptation have also 
been found, »Mue carve\l in iu^rv, i>tben5 in swannvre w\hhI, and >s»>me ha>*e been found fixed 
U|HU^ gi^ld plate*. Of these varnMies, Awu^ arr de|xvsited in the valuable and extensive 
museum beku^giixg t\^ Jiviae|^ Ma>Yr, Fsq., K.S,A.,of Liver|XH^; others arr in the museums 
of B^ilin and l^aiis, and I am in |xvssrssk« of a ux>th R^und piw^ed to a stump in the 
bead of a nuu^uwv in the c\>IWctk^^ of a lanu^nted friend. 

*H>f st\)p|Mi\g with gi^M, seNxral instances bavr c\ui>e u^ my notke^ patticularh in a 
mummy m the Salt c\^lectku\, A4d bv Si^bebv. in i8^^ in which three teeth bad been 
st\>p|^v \ baxe ei^eawuxU t\> tracts the mummy, but in vain/*— K. C. K.] 

♦ l%i^xmale di axctis|H¥Hkn*a pel Ueniisti. iVtoher. iS$i. p. iiv>. 
« lWi^J«c«ihk iirschkhie dec ZlKllll«i&wndl^ ^ ^ 


The distinguished craniologist Prof. Emil Schmidt, of Leipzig, who 
owns a collection of several hundred mummies' skulls, writes thus on 
the question now before us: "In no jaw have I ever found anything 
that could be attributed to the work of dentists: no fillings, no filing or 
trepanning of teeth, no prosthesis."* Virchow, who also examined 
a great many Egyptian skulls, among which were several belonging to 
royal mummies, did not find any indications of dentists' work;' and 
Mummery, as well, although he made the most conscientious researches 
on this subject, could not arrive at any positive results whatever.' 

Between the affirmations of some and the negations of others, it is 
very difficult to say on which side the truth lies. For my own part, I 
fail to find that there is the least proof of the ancient Egyptians having 
known how to insert gold fillings and still less to apply pivot teeth. 
But at the same time I think it cannot be doubted that the Egyptian 
dentists knew how to apply artificial teeth. And even though it may 
not be possible to demonstrate this by direct proof, one is equally prone 
to admit it when one considers, on the one hand, the remarkable ability 
of the ancient Egyptians in all plastic arts, and, on the other hand, the 
great importance they attributed to the beautifying of the human body; 
so much so, that even in so ancient a document as the Ebers papyrus, 
one finds formulae for medicaments against baldness, for lotions for the 
hair, and other kinds of cosmetics. Is it likely, therefore, that so refined 
and ingenious a people should not have found the means of remedying 
the deformity resulting from the loss of one or more front teeth .? 

Fortunately, however, we are not bound to content ourselves with 
simple suppositions, for a well-authenticated archeological discovery made 
in the month of May, 1862, has put us in possession of an irrefutable 

The discovery to which we allude is registered in Renan's Mission 
de Pheniciey and was the result of researches made in the necropolis of 
Saida (the ancient Sidon) by Dr. Gaillardot, Renan's colleague in his 
important scientific mission. In a grave in one of the most ancient parts 
of the necropolis. Dr. Gaillardot found, in the midst of the sand that 
filled the grave, a quantity of small objects, among which were two copper 
coins, an iron ring, a vase of most graceful outline, a scarab, twelve 
very small statuettes of majolica representing Egyptian divinities, which 
probably formed a necklace, to judge by the holes bored in them. But 
among the objects found (which, together with that we are about to 
mention, are now in the Louvre at Paris), the most important of all is 
"a part of the upper jaw of a woman, with the two canines and the 

* Geist-Jacobi, Geschichte der Zahnheilkunde, p. 9. ' Ibid. 

' Ibid. 


four incisors united together with gold wire;' two of the incisors would 
appear to have helonged to another individual, and to have been applied 



e found at Sidon, as represented ir 



n de Phenicie. 

' The incisors represented in the cut of Renan's work do not at all give the anatomical 
form of upper incisors, but of lower ones. Therefore, either the figure itself has been badly 
drawn, or the piece found by Dr. Gaillardoi was part of the inferior and not of the superior 
jaw. In the latter case, the fgure in Renan's book ought to be reversed, in the manner 
here shown: 



sed, as it ought to be if the piece found at Sidon belonged to a lower jaw. 

Neither do we understand on what ground Dr. Gaillardot has based his affirn 
the piece discovered having belonged to a female skeleton, as it is well known that there 
is no characteristic difference between a male and a female jaw. 

[Interesting examples of the survival of this primitive type of dental prosthesis are 
found among the Hindus at the present time. The two illustrations (Figs. J and 6) are 
from photographs of specimens of work done by native Hindu dentists. Fig. 5 is a roughly 
carved artilicial tooth of ivory attached by a gold wire ligature to the adjacent natural 

Fic. 5 

Fig. 6 

iUk 'ialt 

Examples of dental prosthesis as practised by the Hindus at the present time. 

teeth, all of which, with the anificial tooth attached, were (ubsequently lost by alveolar 
disease. Fig. 6 is a similar carved artiRcial tooth of ivory a ~ 

by a thread ligature, the supporting teeth with thr 
lost by alveolar disease. TheK ■pecimefi* 
H. B. Osbom, of Burma, duiini 


as substitutes for lost teeth. This piece, discovered in one of the most 
ancient tombs of the necropolis, proves that dental art in Sidon was 
sufficiently advanced."* 

To these words, literally translated from Renan's work, we will only 
add the following considerations: 

Egypt was, in its time, a great centre of civilization, whose influence 
was strongly predominant in all the neighboring region, and especially 
in ancient Phoenicia and in its large and industrious cities Tyre and 
Sidon. The remains discovered in many of the Phoenician tombs would 
of themselves alone be sufficient to demonstrate luminously the enormous 
influence exercised by the Egyptian civilization on the life and customs 
of that people. Now, if there were dentists in Sidon capable of applying 
false teeth, it may reasonably be admitted that the dentists of the great 
Egyptian metropoli Thebes and Memphis were able to do as much and 
more, the level of civilization being without doubt higher there than in 
Tyre or in Sidon, or in other non-Egyptian cities. 

^ Renan, Mission de Phenicie, p. 472. 


In the Hebrew literature, as principally represented by the Bible and 
by the Talmud, there does not exist any book on medicine. Notwith- 
standing the vicinity and the close relations of the Hebrews with Egypt, 
medical science never reached the degree of development among this 
people that it did in the land of the Pharaohs. 

In the Bible we do not find the least trace of dental medicine or dental 
surgery. Indeed, although the books of Moses contain a great number 
of exceedingly wise hygienic precepts, there are not any that refer directly 
to the teeth or to the mouth. We may therefore conclude, with a certain 
degree of probability, that the Hebrews had in general good teeth and 
that dental affections were very rare among them. 

The word tooth or teeth occurs in the Bible more than fifty times,^ 
but very few of the passages in which it is to be met with present any 
interest so far as our subject is concerned. 

That the Hebrews attached great importance to the integrity of the 
dental apparatus is plainly seen from the following verses of the book 
of Exodus (xxi: 23 to 27): 

23. . thou shalt give life for life, 

24. Eye for eye, tooth for tooth, hand for hand, foot for foot, 

25. Burning for burning, wound for wound, stripe for stripe. 

26. And if a man smite the eye of his servant, or the eye of his maid, 
that it perish; he shall let him go free for his eye's sake. 

27. And if he smite out his manservant's tooth or his maidservant's 
tooth; he shall let him go free for his tooth's sake. 

These legislative measures show clearly enough that among the Hebrews 
the loss of a tooth was considered a lesion of great gravity, as they thought 
it of sufficient importance to be named in the same category as the loss 
of an eye, of a hand, or of a foot. If anyone caused the loss of an eye or 
of a tooth to his servant, the punishment was the same in both cases; that 
is, he was obliged to give him his liberty, thus undergoing the loss of his 
purchase money. 

Beauty and whiteness of the teeth were also in great repute. Thus 
we read in the Song of Solomon (iv: 2): 

* The number varies according to the different *«» 
dentes elephantis, we find in English and in oth' 


"Thy teeth are like a flock of sheep that are even shorn, which came 
up from the washing; whereof every one bear twins, and none is barren 
among them." 

In another part of the Song (vi: 6) he repeats these same words, thus 
giving it to be understood how great was his admiration for the beautiful 
teeth of his beloved. 

From various passages of the Bible, one perceives that integrity and 
soundness of the teeth was considered a prime element of force and vigor. 
In Psalm iii: 7 David says: "Arise, O Lord; save me, O my God: 
for thou hast smitten all mine enemies upon the cheek bone; thou hast 
broken the teeth of the ungodly." (That is, reduced them to impotence.) 
And in Psalm viii: 6 we read: "Break their teeth, O God, in their 

On the other hand, in one of the Proverbs of Solomon (xxv: 19), 
broken or decayed teeth are taken to symbolize weakness: "Confidence 
in an unfaithful man in time of trouble is like a broken tooth, and a 
foot out of joint." (In the Latin translation, instead of "broken tooth" 
stands "dens putridus." Perhaps the corresponding expression in the 
Hebrew language, signifies in a general sense a decayed or injured tooth.) 

The uncomfortable sensation produced on the teeth by acid substances 
(teeth on edge) is to be found several times alluded to in the Bible. In 
the Book of Proverbs (x: 26), one reads: "As vinegar to the teeth, and 
as smoke to the eyes, so is the sluggard to them that send him." And 
Jeremiah says (xxxi: 29, 30): "In those days they shall say no more. 
The fathers have eaten a sour grape, and the children's teeth are set on 
edge. But every one shall die for his own iniquity; every man that 
eateth the sour grape, his teeth shall be set on edge." 

As is apparent, there is nothing in the passages quoted that can be in 
any way connected with the treatment of dental affections; neither is it 
to be wondered at, when one reflects that even in the Talmud — ^which is 
much less ancient — medicine in general is hardly at all spoken of. This 
famous code as to practical life is almost silent with regard to therapeutic 
medicine, and only recommends hygienic practices. An axiom of the 
Rabbi Banaah is worthy of note, and may be quoted here as bearing on 
the subject, and also because many Christians might be found to conform 
willingly thereto: 

"Wine is the best of all remedies; and it is in places where wine is 
wanting that one is in need of pharmaceutic remedies."* 

' J. Bouillet, Precis d'histoire de la Medecine, Paris, 1883, p. 24. 


For above 4000 years science and religion among the Chinese, as 
well as their customs, have remained quite unchanged. The inhabitants 
of the Celestial Empire can vaunt a most ancient civilization; which is, 
however, altogether stationary; neither has their medicine made any 
progress, and its actual state represents with sufficient exactness what 
it was in primitive ages. 

In Europe, various works have been written about the medicine of the 
Chinese, one of the best being that of Dabry,* taken from the most 
celebrated medical books of China,' and which may be considered as 
a compendium of the medical science of this people. 

In this work we find two chapters relating to our specialty: the first 
of these (p. 286) speaks of toothache, the second (p. 292) treats of all the 
other dental and gingival diseases. 

The Chinese call the toothache ya-tongy and distinguish a great many 
varieties of the malady, that is: 

1. Fong'je-tong. This kind of toothache is caused by sudden cold, 
and has the following characteristic symptoms: Red and swollen gums, 
which after a little time discharge purulent and fetid mucus ; abundant 
salivation; acute pain; swelling of the cheek. It is to be cured with 
draughts, mouth washes, and various kinds of frictions. 

We consider it useless to give the particulars of the various receipts, 
because Dabry hardly ever translates the names of the drugs of which 
they are compounded. These formulae are therefore incomprehensible 
by most people. 

2. Fong'lari'tong, This kind of toothache is also caused by cold. The 
pain is very great, but the gums are neither red nor swollen. 

3. Te-tong. Is also produced by chill. The gums are red and swollen; 
there is no discharge of mucus; great pain, which is aggravated by cold 
liquids. If the malady lasts for some time, the gums end by becoming 
black, and the teeth are loosened; the pain becomes more intense in 
spitting. In this stage of the malady the sufferer no longer fears cold 
drinks, but rather desires them, to soothe the pain. The cure varies 

* La medecine chez les Chinois, par le Capitaine P. P. Dabry, Consul de France en Chine, 
Membre de la Societe Asiatique de Paris, 1863. 

' One of these books, Nuei-King, is said to hav« I 
before the Christian era, by the Empeio" 



according to whether the malady be of recent or of old date; it consists 
in the use of internal remedies (pills, potions), or of frictions on the part 
where the pain is situated. 

4. Han^tong, This is also owing to the action of the cold. Pains in 
the cheek and forehead proceeding from the teeth; no diseased con- 
dition either of the gums or of the alveoli. 

5. Tou^tan-tong. Violent cough and toothache at the same time; 
difficulty in masticating. 

6. Tn-hiue-totig, The gums are pale, or violet-red, hard and lumpy, 
sometimes bleeding; the toothache is continuous. Among the numerous 
remedies recommended against this malady (mouth washes, frictions, 
draughts, pills), one particularly deserves mention: it is the urine of a 
child used as a mouth wash. 

7. Tchong-che-tong. Pain in the teeth after mastication; there is 
also sometimes excoriation of the gums ; flow of purulent mucus mixed 
with blood ; bad-smelling breath ; the tooth falls ; it is decayed, and 
one can perfectly well distinguish a small hole ; the root is unsound ; 
in extracting the tooth one sometimes brings away together with it a 
little white worm, with a black spot on the head, which can be distin- 
guished by the aid of a magnifying glass. A remedy must immediately 
be administered to destroy these worms, otKerwise the patient runs the 
risk of having his other teeth attacked in the same manner, and of their 
falling out. The remedies against this afl^ection are most numerous, 
and belong for the most part to the oftentimes cited categories. One of 
them presents a certain interest, its basis being arsenic. 

In Dabry's book it is described in the following manner: "Arsenic 
(gr. 1.80), houang'tan (gr. 3.60); pulverize, mix with water, and with 
a part of the mass form a small pill, which put close to the aching tooth 
or into the ear, if afraid of the arsenic; then sleep. Cure certain." 

8. Toothache, the effect of general weakness, following principally 
on abuse of coition. It is to be cured by the use of internal medicine, 
or by local remedies to be rubbed on the painful spot. Some of the 
medicaments registered in this paragraph have reference to the special 
case, in which the teeth are loosened through excess of coition. Among 
others there is a prescription for a dentifrice powder for strengthening 
the teeth, to be used every morning. 

9. Toothache following on a blow. It is to be cured by using a 
certain dentifrice powder, composed of six ingredients. Another medi- 
cament consists in heating about an ounce and one-half of silver in some 
recipient, and then pouring wine upon it, and rinsing the mouth with it. 

Besides these nine kinds of toothache, the Chinese doctors recognized 
a peculiar morbid condition of the teeth and their surrounding parts, 
which is thus described in Dabry's book: 


"It sometimes occurs, after recovery from illness, that convalescents, 
in order to acquire strength, drink too great a quantity of wine; and 
that this after a certain time produces a beginning of inflammation of 
the stomach. In such cases the teeth often fall out, the breath becomes 
fetid, and if the patient eats hot food, the empty alveoli as well as the 
cheeks are painful." 

Various internal medicaments and dentifrice powders are prescribed for 
combating this morbid condition. One of these latter includes a great 
number of ingredients in its composition ; amongothers, the bones of mice. 

Mention is also made of certain remedies, to which recourse may be 
had at times, for allaying violent dental pains, of whatsoever kind, or 
whatever be the cause that occasions them. 

One of these remedies is composed of different substances (among 
them, garlic and saltpetre), to be pulverized and made into pills. If 
the pain be on the left side, one introduces one of the pills into the right 
ear, and vice versa. 

The formula is also given for a very complicated medicated powder, 
to be snuffed up in the left nostril if the person suffering from tooth- 
ache be a man; in the right if a woman. 

Another powder is to be smelt with the right nostril or with the left, 
corresponding to the side on which the pain is located. 

Abscesses and fistulae of the gums are spoken of as follows: 

"It sometimes occurs that an abscess forms in some one point of 
the gum ; this communicates great pain to the tooth near it ; the abscess 
is white, with discharge of purulent matter." The treatment consists 
in the use of different medicated powders, to be rubbed on the affected 
part. Two of the powders contain musk, besides several other ingredi- 
ents. A lotion is also prescribed. 

In the next chapter the following affections are described: 

1. Ta-heou. Gums are red, soft, and swollen, and a fetid and 
purulent matter exudes from them ; the teeth are not painful ; if the 
gums are lanced, blood of a pale red color flows from them in abun- 
dance. This malady is to be treated with various internal medicines 
and sometimes with scarification. 

2. Ja-suen, Gums swollen; little by little they are corroded and 
destroyed by ulceration, which leaves the roots of the teeth bared; the 
patient has an aversion for hot food; continued pain in the teeth; 
discharge of purulent and fetid mucus; by the slightest exposure to 
cold the pain becomes very violent. This affection is to be combated 
with internal remedies and local treatment (frictions with medicated 
powders; application of an ointment of very complicated preparation). 

3. Tchuen-ya-kan. The gums are painful for a few days; appari- 
tion of the root of the tooth; absence of ulceration. Children of five 


or six years of age are frequently exposed to this malady. The best 
means of cure consists in the extraction of the tooth. There are, besides, 
various internal and external remedies prescribed. One of these latter 
contains verdigris and three other ingredients. Among those to be 
used internally there is a decoction prepared with twelve different 
drugs, two of which are mint and rhubarb. The quantity of rhubarb is 
about seven and one-half grams; therefore, this prescription is certainly 
intended to act as a purgative. 

4. Ta-ting, The right or left gum suddenly swells; a tumor forms 
of about the size of a grain of sorgo; in the beginning it is red, after- 
ward black ; severe pain in the cheek and neck ; itching in the cheek ; 
the tumor afterward bursts, giving exit to blood, and becomes black ; 
it ought to be pricked directly (before it opens of itself) with a silver 
needle; blood of a violet color will flow from it, which should be left 
free course until it regains its ordinary color. The sufferer has at the 
same time pains in the stomach, great thirst, abdominal pains, and 
sometimes even delirium. 

5. Ta-jong. Gums swollen and painful, abscess, fever, swollen 
cheeks; great thirst, and vomiting of a liquid kind; dejections dry. 
The treatment consists in the methodical use of certain medicines 
to be used internally, among which is rhubarb. If one neglects to 
make use of this treatment, an ulceration sets in with discharge of a 
purulent and sanguine mucus; it is then necessary to rub the part with 
a medicinal substance called by the Chinese, ping-pang-san. Should 
the tooth be somewhat loose, it ought to be extracted and the gum 
rubbed again with the substance just now named. 

6. Tso'tna-ya-kan. An illness common to children after the small- 
pox; ulceration of the gums, which turn black; fetid breath. In certain 
cases the gums are hard and the mucous membrane of the cheek is also 
attacked; all the teeth shake; there is flow of blood from the gums, 
upon which certain spots begin to form that are clearly distinguishable 
as small holes. These holes must be filled with a particular medicinal 
substance (named lay-ma'ting-kouei'Sse)^ and, besides, one ought to make 
use of various other internal and external remedies. 

This is a very serious illness. In the case of recovery, the patient 
ought to abstain from taking any heating aliment for one hundred days. 

7. Tsee-kin-tong or tsee-ly-tong. Gums swollen; slight but continuous 
pain, aggravated by the eflx)rt of the wind ; the gums become ulcerated 
little by little, with discharge of purulent and sanguine mucus; and the 
root of the tooth is afterward seen to be uncovered. This malady is 
to be treated by means of draughts, pills, mouth washes, and. frictions 
of various kinds. 

After the treatise on the maladies referred to above, we find in Dabry's 


book a long series of "general remedies for every kind of toothache." 
There are about forty of these, and decoctions and powders predominate 
among them, the latter to be rubbed on the painful spot. Decoctions 
are the form of medicament most in use among the Chinese. In this 
list of about forty anti-odontalgic remedies we find as many as eighteen 
decoctions, seven for internal use, and the others to be employed as 
mouth washes. Some of the latter are compounded with vinegar 
instead of with water. 

Four remedies of the above list are to be made into a paste and formed 
into pills, to be applied upon the aching tooth. 

Another medicament is also to be formed into pills and applied inside 
the ear. 

The following remedy is particularly worthy of note: 

"One roasts a bit of garlic, crushes it between the teeth, and after- 
ward mixes it with chopped horseradish seeds, reducing the whole to 
a paste with human milk; one then forms it into pills; these are to be 
introduced into the nose on the side opposed to that where the pain 
is situated." 

Two other remedies, in powder, are to be snuffed up through the 

A powder to prevent the progress of caries is prescribed, with which 
the tooth should be rubbed every day, or it may be applied on the decayed 

Finally, two powders are also prescribed for whitening the teeth. One 
of these is compounded of seven ingredients, among which is musk; 
the other has only three substances in its composition: salt (gram 25), 
musk (gram 1.8), tsang-eul-tsee (gram 36). 

A therapeutic method much in vogue among the Chinese is acupunc- 
ture, which is used in the treatment of the greatest variety of affections, 
including those of the dental system. The doctors of the Celestial 
Empire have the greatest faith in this operation, which they hold 
capable of removing obstacles to the free circulation of humors and 
vital spirits, thus reestablishing that equilibrium of the organic forces 
which constitutes health, and the absence of which causes disease. 

The Chinese doctors prefer to use gold or silver needles for punc- 
turing; but they also frequently use needles of the best steel. These 
instruments vary very much in length, in thickness, and in form, and 
there are not less than nine distinct kinds of puncturing needles. 

Every doctor who intends dedicating himself to the practice of this 
operation has to begin by the most accurate study of the elective points 
for puncturing according to the various affections ; he should also 
know to what depth precisely to drive the needles in each case, in order 
to reach the site of the morbific principle and procure convenient exit 


for it; he ought to know equally well how long to leave the needle in 
the affected part, so as to obtain the best possible therapeutic results 
in each case. 

The points of election for carrying out puncturing in various maladies 
are spread over the whole superficies of the body, and amount in number 
to 388. Each of these is known by a special name. Each site of election 
stands in determinate relations, as to distance, to the known anatomical 
points, and may, therefore, be easily and precisely found by appropriate 
measurement. The unity of length for these measurements is called 
tsuny and is divided into ten fen; its value varies, however, according to 
whether the said measurements be taken on the head, the trunk, or the 
extremities. For the head, the length of the tsun is calculated as equal to 
the distance existing between the inner and the outer angle of the eye; for 
the trunk, it is equivalent to the eighth part of the horizontal line between 
the two breast nipples; and for the extremities, it is equal to the length 
of the second phalanx of the middle finger, measured with the joints 

There are twenty-six points of election upon which to carry out punc- 
turing used as a remedy against toothache. There are also six other 
points of election for pains in the gums. 

One would naturally be disposed to believe that these points of election 
would be situated in proximity to the teeth. Instead, many of them are 
situated in distant parts of the body — for example, in the elbow, in the 
hands, the feet, the vertebral region, the coccyx, and so on. However, 
about half of them are to be found in the labial, maxillary, and peri- 
auricular regions. 

The puncturing of every point of election is almost always indicated 
for the cure of not only one but several, and, indeed, very often many, 
maladies; for example, the puncture carried out on the point of election, 
kin-tchey situated at the outer extremity of the bend of the elbow, may 
be utilized in more than twenty-five morbid conditions ; among which 
are pains in the arm, paralysis of the arm, edema of the whole body, 
excessive perspiring, vomiting, hematemesis, toothache, boils, gastralgia, 
hemiplegia, and even cholera! 

This mode of cure depends on the special relation of each point of 
election to the so-called canals of transmission and communication 
(named in Chinese king) through which the blood and the vital spirits 
circulate, and which serve at the same time to transmit the "innate heat" 
and "the radical moisture" to all parts of the body. 

And here we must be allowed a brief digression in explanation of what 
we have just said. 

The anatomical notions of the Chinese are very erroneous;^ their 

' See Bouillet, work quoted at p. 31. 


ideas on the functions of the human body and of human life in general, 
differ considerably from ours. They recognize two natural principles 
of vitality, one they call yang (vital, primordial, or ** innate heat"), the 
other yn (radical moisture). The spirits (that is the air) and the blood 
serve as vehicles to these two essential principles of life ; that is, vital 
heat and radical moisture. The constant equilibrium, the accord, the 
perfect union of these two essential principles of life constitute a state 
of health. From their alteration, corruption, or disunion originate all 

There are twelve principal sources of vitality in the human organism ; 
that is, twelve organs from which the two aforesaid vital principles are 
distributed throughout the body: The heart, the liver, the two kidneys, 
the lungs, and the spleen are the seat and origin of radical moisture; 
the large and the small intestine, the two ureters, the gall-bladder, and the 
stomach are the seat and origin of vital heat. These twelve sources of 
life are in intimate relation with one another by means of the canals 
of communication, through which the blood and the vital spirits (air) 
circulate, carrying with them into every part of the body vital heat and 
radical moisture.* 

The points of election upon which to carry out puncturing are situated 
along the course of the large lines of communication and transmission; 
and that explains, according to the Chinese medical theories, why a 
puncture carried out on a given point of the body can prove useful in 
relieving a variety of maladies even in distant parts of the organism. 

Puncturing is almost always associated with cauterization, for after 
having drawn out the needle, it is usual to cauterize the site of the punc- 
ture with the so-called "mox^," that is, with a kind of vegetable wool 
obtained from the leaves and dried tips of the artemisia. One com- 
presses this substance very tightly between the fingers into the shape 
of a small cone. One next applies a small coin with a hole in the 
centre upon the site of election ; the cone of moxa is placed on the 
hole in the coin and lighted at its top. As the cone is very compact, 
it burns slowly enough, without developing excessive heat, so that, 
according to Ten Rhyne,^ who was an enthusiast for this mode of cure, 
"the epidermis is drawn without violence and rises gently into a small 
blister. The moxa, whilst burning, draws out the peccant humors 
visibly, absorbing them in such a manner that they are totally con- 
sumed without destroying the skin itself." 

The application of the moxa is not as painful as might be thought, 

* Dabry, op. cit., p. x (introduction), pp. i, 2, 4, 10, 11. 

' This author wrote toward the end of the seventeenth century ; one of his works is entitled 
De Acupunctura. 


and even children support it without much crying. The number of 
times for repeating the operation varies according to the malady and 
the site of application, etc. Thus, in the point kin-tchey which we have 
mentioned once before, the cauterization is generally repeated seven 
times, but in certairr cases the number may be brought up to 200. 

There are certain points of election for which puncturing alone is 
prescribed without subsequent cauterization; in other instances, the punc- 
turing is held to be unnecessary or even dangerous; one, therefore, only 
applies the moxa in these cases.* 

In Japan, the moxa was still more in use than in China. According 
to Ten Rhyne, from the remotest times the moxa has been the best and 
almost the sole mode of treatment for illness in Japan, and was regarded 
not only as an excellent remedy, but also as an excellent preservative; 
so much so that even convicts condemned to perpetual imprisonment 
had permission to go out every six months to undergo this cure. 

Dental affections also were especially treated with the moxa, and, 
judging by what Ten Rhyne says on the subject, it would seem that 
this caustic, when used against toothache, was usually applied in the 
region of the mental foramen.^ 

' Dabry, op. cit., p. 424. 

* See Histoire de la Chirurgie depuis son origine, par MM. Dujardin et Peyrihie, Paris, 
1774 to 1780. 



Joseph Murphy, in his book, A Natural History of the Human Teethy^ 
says that the natives of Hindostan, especially the Brahmins or priests 
of Brahma, take extreme care of their teeth. Every morning they rub 
them for about an hour with a small twig of the fig tree, at the same 
time that, turned toward the rising sun, they recite their prayers and 
invoke Heaven's blessing on themselves and their families. As this 
custom is prescribed in the most ancient codes and religious writings of 
India, it reverts, without doubt, to the remotest ages, and, therefore, 
demonstrates the great importance that this people, and particularly the 
Brahmin caste, has ever attributed to beauty and cleanliness of the teeth. 
Murphy affirms that the Brahmins, in general, have magnificent teeth ; 
and that this depends, certainly in great part, on the assiduous and 
scrupulous care that they take of them. 

From the writings of their ancient poets one also deduces in what high 
esteem the people of India held beautiful teeth, considering them one 
of the principal ornaments of the face. The lover, says Murphy, never 
neglected, in enumerating the beauties of his lady-love, to praise the 
whiteness and regularity of her teeth. 

Among some of the people of India, when the second dentition is 
completed, it is customary to separate the teeth one from the other with 
a file; we do not know, however, whether this is done as an embellish- 
ment or with some other object — perhaps, as suggested by Joseph 
Linderer,^ to prevent caries. 

Anyhow, this and other customs in vogue in various parts of India 
and in many islands of Oceanica demonstrate that these peoples attribute 
great importance to the teeth. 

The substituting of gold teeth for those missing has been in use in 
Java from exceedingly remote times.' 

Dyeing the teeth black is considered a great embellishment among 
many races of Asia and Oceanica; this operation is sometimes preceded 

^ London, 1811. 

' Die Zahnheilkunde, etc., 1851, p. 347. 

' J. Bontii, De medicina Indorum, 1642, lib. iv. 


by another, viz., the filling up of the interdental spaces very cleverly 
with gold leaf.* 

In Sumatra and the neighboring islands many women file their teeth 
down to the gums; others file them into points; or partially remove the 
enamel so as to render it easier to apply the black dye; this being held 
to be the height of elegance. Men of high rank and condition dye their 
upper teeth black and cover the lower ones with fine gold plates, which 
in a full light produces what they consider a fine contrast. The natives 
of other islands gild the upper central incisors and dye the others black.' 

In Japan, the married women may easily be distinguished from the 
others by their black and shining teeth. The coloring preparation they 
use to blacken the teeth is composed of urine, raspings of iron, and a 
substance called saki. This mixture has a most unpleasant odor, and 
if applied on the skin acts as a caustic. Its action on the teeth is so 
powerful that they do not regain their whiteness even after a lapse of 
years. In applying this substance, and also for some time after, the 
women take care to preserve their gums and lips from its efl^ects, as it 
would otherwise cause them to assume a dark blue tint." The inhabi- 
tants of the Pelew Islands make use of the wild thistle and shell chalk 
to blacken the teeth. It is also the custom to blackernthe teeth among 
the inhabitants of Tonkin and Siam, the women of the Maria Islands, 
and the single ladies of Java. 

Some of the peoples of Eastern India plane their teeth down to an 
even level; and from the habit of masticating areca nuts mixed with 
chalk and other substances, their lips and teeth are dyed red. At 
Macassar the natives have their teeth dyed red; they also substitute 
missing teeth by artificial ones made of gold, silver, or tombac* 

Negroes, especially those of Abyssinia, very often file their incisors 
into points to resemble the form of the canines; this is in order to give 
themselves an air of greater ferocity. 

Murphy relates that the inhabitants of one of the islands of the Sound 
make an incision in the upper lip in a parallel line with the mouth, and 
large enough to allow the tongue to pass. After the margins have healed 
they have a great resemblance to the lips. This kind of artificial mouth 
is made to support a shell, carved in such a manner as to produce the 
efl^ect of a row of teeth. 

The natives of the Sandwich Islands sacrifice their front teeth to 
conciliate the favor of their god Eatoa.* 

* Carabelli, Handbuch der Zahnheilkunde, 1844, i, 8. 
' Linderer, op. cit. 

' [The newer civilization of Japan has caused this custom to largely fall into disuse. 
— E. C K.] 

* Carabelli, loc. cit. » Linderer, loc. cit. 


Among the natives of New South Wales, it is the custom when a youth 
reaches virility to knock out his front teeth with a stone; this operation 
being carried out by the kuradshis or wizards. 

The savages of Peru are also in the habit of making the front teeth 
fall out; the reason of the custom is that the space thus made is regarded 
by them as an embellishment.^ 

* Carabelli, op. cit., p. 17. 


An ancient Greek physician — Asklepios, afterward called iEscu- 
lapius^ — by the ability he displayed in the art of healing, so impressed 
the minds of the simple and uncultured at that primitive epoch as to be 
held in repute rather as a god than as a man. Not only was he held to 
be the author of wonderful cures, but it was also affirmed that he had 
resuscitated the dead; no doubt from his having in some case or other of 
apparent death restored the individual to consciousness by the assistance 
he rendered him. Exaggeration, so natural to ignorant minds, after- 
ward did the rest, and magnified the healing and restoring powers of 
iEsculapius to such an extent that it is not to be wondered at that he 
should have been looked upon as a divine being. With the lapse of time, 
various traditions formed around his name, among which there was, 
however, finally such discrepancy that the popular voice spoke no more 
of one, but of many ^Esculapii,^ and to one of these was attributed, 
among other merits, that of having invented the probe and the art of 
bandaging wounds, while another was held to be the inventor of purga- 
tives and of the extraction of teeth. 

According, therefore, to these traditions, dental surgery had its origin 
with iEsculapius, the god of Medicine. But what was the precise epoch 
in which this benefactor of humanity lived ? 

We learn from Homer that two sons of ^Esculapius, Machaon and 
Podalirius,' took special part, as doctors, in the siege of Troy. This 
celebrated siege, which lasted ten years, took place in the twelfth century 
before the Christian era (that is, 1193 to 1184 B.C.); admitting, therefore, 
the account of the parentage to be authentic, one may argue therefrom 
that ^sculapius must have lived between the twelfth and thirteenth 
centuries B.C. Many temples were built and dedicated to ^sculapius ; 
these were called asklepeiay after the Greek form of his name. The priests 
were called Asklepiadi^ and alleged their direct descent from iEsculapius 

* The Greek name Asklepios became in the Latin, -^sculapius; the two names are there- 
fore equivalents. 

' See Cicero, De Natura deorum, lib. iii, chap. xxii. 

' [Homer speaks of them as "two excellent physicians," and refers to Machaon as "a 
blameless physician/' and admits that "a medical man is equivalent to many others." 
Their renown was continued in a poem of Arctinus, wherein one was represented as 
without a rival in surgery, the other as sagacious in detecting morbid symptoms. — C. M.] 


The temples of iEsculapius became so numerous in time that they 
were to be found in almost every Greek city. The most celebrated were 
those of Epidaurus, Cos, Cnydus, and Rhodes, as well as that of the great 
city of Agrigentum, in Sicily. The Asklepiadi not only performed the 
temple rites, but were doctors at the same time, for as interpreters of the 
wisdom of the god, they also occupied themselves in curing the sick. 
From this it resulted that these temples became in time, through observa- 
tion and experience, schools of medical science. 

But besides this sacerdotal medicine, there was also a lay medicine in 
Greece. Many great philosophers, especially Pythagoras, Alcmeon of 
Croton, Empedocles, Anaxagoras, and Democritus, occupied themselves 
with physiology, with hygiene, and with medicine; also the gymnasiarchs, 
or directors of gymnasiums, or schools of gymnastics, an art having 
for its end to increase physical strength and maintain health, cultivated 
medicine, particularly that part of it which concerns hygiene, dietetics, 
and surgery as applied to the treatment of violent lesions, such as fractures, 
luxations, etc. 

The Asklepiadi often themselves imparted the principles of medicine 
to students outside their caste. Lay medicine thus gradually came to 
supplant sacerdotal medicine, especially after Hippocrates, who through 
his works, exercised a preponderant influence in the secularization of 
the science. However, the Asklepiadi, on their side, continued to practise 
medicine up to the time when the pagan temples fell into complete ruin, 
through the advance of Christianity. 

On the columns of the asklepeia and on the votive tables were written 
the names of those cured by the god, together with indications regarding 
their various maladies and the treatment by virtue of which the sick had 
been restored to health. 

Surgical instruments of proved utility were deposited in the temples. 
Celius Aurelianus makes mention of a leaden instrument used for the 
extraction of teeth {plumbeum odontagogori)y which was exhibited in the 
temple of Apollo, at Delphi. 

As a matter of fact, it would seem more natural that this instrument 
should have been shown in the temple of iSsculapius, he being the god 
of Medicine, and believed, besides, to be the inventor of dental extraction. 
One is rather inclined by this to think that the oJohtagogon may have 
been deposited in the temple of Apollo before the building of iSscuIapian 
temples. Indeed, who can tell if i^sculapius himself, not yet deified, 
may not have deposited there a model of the instrument he had invented ! 

From the fact of the odontagogon in the temple of Apollo being made 
of lead, Erasistratus, Celius Aurelianus, and other ancient writers have 
drawn the deduction that it was only permissible to extract teeth when 
they were loose enough to be taken out with a leaden instrument. But 


Serre' observes, not without reason, that if a tooth be so unsteady as 
to be able to be extracted with leaden pincers, this may just as well 
be done, and perhaps even better, by pinching the tooth between the 
fingers, no other aid being required than a handkerchief to prevent them 
from slipping. Avulsive pincers of lead would be, therefore, a nearly 
useless invention; so it is much more probable, as Serre remarks, that 
the original pincers were of iron, and that the inventor, reserving these 
for his own use, made a simple model of the same in lead (this being 
easier to do) and deposited it in the temple of Apollo, in order to make 
known the form of the instrument to contemporaries and to posterity, 
naturally supposing that whoever wished to copy it would understand 
of himself, or learn from the priests, that it was to be made of iron and 
not of lead . 

Fig. 7 

Phceniciiin origin, found In Crimea (see 
~ osthcsis, pp. 60-65 snd 187). 

Hippocrates. The sacerdotal and philosophical schools of medicine, 
as well as the gymnasiums, were the three great sources whence Hip- 
pocrates derived his-first knowledge of medicine. 

Hippocrates was born in the island of Cos, toward the year 460 B.C. 
He belonged to the sacerdotal caste of the Asklepiadi, and was, according 
to some of his earliest biographers, the nineteenth descendant of jEscu- 
lapius on his father's side, and the twentieth descendant of Hercules on 
his mother's side. The time of his death is even still more uncenain 

' Prakiische Darstellung aller Operationen der Zahnarznei-kunst, von Johann Jakob 
Joseph Serre, Berlin, pp. 7 to 13. 


than that of his birth, for, according to some, he died at eighty-three, 
according to others, at eighty-five, at ninety, at one hundred and four, 
and even at one hundred and nine years of age. 

Hippocrates was initiated in the study of medicine by his own father, 
Heraclides; but in the medical art he also had as a teacher the gymnasi- 
arch Herodicus of Selymbria; besides, he studied eloquence under the 
sophist Gorgia and philosophy under the celebrated Democritus. He 
treasured up all the records of medical practice that were preserved in 
the temple of Cos; but according to some ancient authors he is said to 
have set fire afterward to this temple, and to have left his native country 
in order to flee from the resentment he had aroused. Probably it was 
the priests themselves who attributed the burning of the temple (which 
certainly took place at that time) to Hippocrates, out of jealousy for his 
growing fame; though it may also be possible that this great man, having 
first collected together all that was useful among the medical records that 
were to be found there, afterward courageously destroyed this centre of 
superstition, so that medicine, ceasing to be confused with imposture 
and being despoiled of the supernatural character attributed to it, which 
paralyzed its progress, should become a liberal and human art, based 
purely on the observation of clinical facts and the study of natural laws. 

For a long time, Hippocrates travelled in various parts of Europe, 
Asia, and Africa, everywhere making valuable observations. He finally 
returned to his native country, where through the practice of medicine 
and by his immortal writings he acquired such esteem and veneration 
that his compatriots almost tributed him with divine honors after death. 

Not all, however, of the works that make up the so-called collection 
of Hippocrates were really written by the father of medicine. Two of 
his sons — Thessalus and Draco — and his son-in-law Polybius also dis- 
tinguished themselves by the practice of medicine and by their admirable 
writings, which together with those of other doctors of that period were 
erroneously included in the collection of Hippocrates' works. At any rate, 
the collection of Hippocrates faithfully represents the state of medicine 
and surgery at the epoch in which he and his disciples flourished, that is, 
toward the end of the fifth and during the fourth century before the 
Christian era.^ 

Neither Hippocrates nor others before him had ever dissected corpses; 
it is, therefore, not to be wondered at that the anatomical notions con- 
tained in the Hippocratic works should be scarce and very often inexact. 
The physiological notions also are highly deficient and imperfect, which 
is, indeed, very natural, for an exact knowledge of the functions of the 
human body presupposes an exact knowledge of the relative organs. 

^ Guardia, Histoire de la Medecine, p. 250. 


The philosophical ideas of the time had considerable influence on the 
medical theories of Hippocrates and his successors. The universe was 
considered as constituted by four elements: earth, air, fire, water. 
To each of these elements a special quality was attributed, and, thus, 
one recognized four fundamental qualities, viz., cold, dryness, heat, and 
moisture. Man — the most perfect being — was regarded as a "micro- 
cosmos," or small world in himself, that is, a sort of compendium of the 
whole universe, and his organism, in correlation to the four primordial 
elements of the universe, was believed to be constituted of four funda- 
mental humors — the blood, the pituita or mucus, the yellow bile, and 
the black bile or atrabile. 

Health, says Hippocrates,^ depends on the just relation one to another 
of these principles, as to composition, force, and quantity, and on their 
perfect mixture; instead, when one of the four principles is wanting or 
in excess, or separates itself from the other components of the organism, 
one has a diseased condition. In fact, he adds, if some one humor flow 
from the body in a measure superior to its superabundance, such a loss 
will occasion illness. If, then, the humor separated from the others col- 
lect in the interior of the body, not only the part that remains deprived 
of its presence will suflFer, but also that into which the flow takes place 
and where the engorgement is produced. 

We have here briefly stated these generalities in order to make 
ourselves clearly understood in speaking hereafter on diflFerent subjects, 
whether with regard to Hippocrates or to other authors of the time. 

In the works of Hippocrates there is not one chapter that treats sepa- 
rately of the aflFections of the teeth, just as there is no book in which 
he speaks separately of diseases of the vascular or nervous systems, and 
so on. There are, nevertheless, a great number of passages scattered 
throughout the Hippocratic collection from which we can deduce very 
clearly the great importance that the Father of Medicine ascribed to the 
teeth and to their maladies. 

In the book De carnibusy the formation of the teeth is spoken of among 
other things. It might have been supposed that Hippocrates would have 
been ignorant of the fact that the formation of the teeth commences in the 
intra-uterine life. This, however, is not the case; in fact, he says: "The 
first teeth are formed by the nourishment of the fetus in the womb, and 
after birth by the mother's milk. Those that come forth after these are 
shed are formed by food and drink. The shedding of the first teeth 
generally takes place at about seven years of age, those that come forth 
after this grow old with the man, unless some illness destroys them."' 

* Hippocratis opera, Genevse, 1657 to 1662, De natura hominis, p. 225. 
^ Page 251. 


And a little farther on one reads: "From seven to fourteen the larger 
teeth come forth and all the others that substitute those derived from the 
nourishment of the fetus in the womb. In the fourth septennial period 
of life there appear in most people two teeth that are called wisdom 
teeth." ^ 

There is a passage in this same book De carnibusy in which the great 
importance of the teeth for clear pronunciation of words is alluded to: 
"The body," says Hippocrates,^ "attracts the air into itself; the air 
expelled through the void produces a sound, because the head resounds. 
The tongue articulates, and by its movements, coming into contact with 
the palate and the teeth, renders the sounds distinct." 

The book De dentitione is written in the form of brief sentences or 
aphorisms, and speaks of the accidents that often accompany the eruption 
of the deciduous teeth. The most important passages in this short 
treatise are the following: 

"Children who during dentition have their bowels frequently moved 
are less subject to convulsions than those who are constipated." 

"Those who during dentition have a severe attack of fever rarely have 

"Those who during dentition do not get thinner and who are very 
drowsy run the risk of becoming subject to convulsions." 

"On conditions of equality, those children who cut their teeth in the 
winter get over the teething period the best." 

" Not all the children seized with convulsions during dentition succumb 
to these ; many are saved." 

" In the case of children who suffer with cough the period of dentition 
is prolonged, and they get thinner than the others when the teeth come 

In the third book of Aphorisms, where Hippocrates speaks of the 
illnesses that prevail in the various seasons of the year and in the various 
ages of life, mention is also made of the accidents of dentition. The 
twenty-fifth aphorism says: "At the time of dentition, children are 
subject to irritation of the gums, fevers, convulsions, diarrhea; this occurs 
principally at the time when the canines begin to come forth, and in 
children who are very fat or constipated." 

The works of Hippocrates are nearly silent on the hygiene of the teeth; 
but in the second book, on the diseases of women,' some prescriptions 
are to be found against bad-smelling breath. We translate the passage 

"When a woman's mouth smells and her gums are black and un- 
healthy, one burns, separately, the head of a hare, and three mice, after 

» Page 252. ' Page 253. ' De morbis mulierum, lib. ii, p. 666 


having taken out the intestines of two of them (not, however, the liver or 
the kidneys); one pounds in a stone mortar some marble or whitestone,* 
and passes it through a sieve; one then mixes equal parts of these ingredi- 
ents and with this mixture one rubs the teeth and the interior of the mouth; 
afterward one rubs them again with greasy wooP and one washes the 
mouth with water. One soaks the dirty wool in honey and with it one 
rubs the teeth and the gums, inside and outside. One pounds dill and 
anise-seeds, two oboles of myrrh;' one immerses these substances in half 
a cotyle* of pure white wine; one then rinses the mouth with it, holding it 
in the mouth for some time; this is to be done frequently, and the mouth 
to be rinsed with the said preparation fasting and after each meal. It is 
an excellent thing to take small quantities of food of a very sustaining 
nature. The medicament described above cleans the teeth and gives 
them a sweet smell. It is known under the name of Indian medicament." 

In the book De affectionibus there is a passage where it is said that 
inflammation of the gums is produced by accumulations of pituita, and 
that, in like cases, masticatories are of use, as these remedies favor the 
secretion of saliva, and thus tend to dissipate the engorgement caused 
by pituita. 

Still more important, however, is the following passage of the same 

" In cases of toothache, if the tooth is decayed and loose it must be 
extracted. If it is neither decayed nor loose, but still painful, it is 
necessary to desiccate it by cauterizing. Masticatories also do good, 
as the pain derives from pituita insinuating itself under the roots of the 
teeth. Teeth are eroded and become decayed partly by pituita, and 
partly by food, when they are by nature weak and badly fixed in the 

Hippocrates, therefore, considers aflFections of the teeth to depend 
in part on natural dispositions, that is, on congenital weakness of the 
dental system, in part on accumulations of pituita, and the corroding 
action of the same. If a painful tooth were not loose, it was not to be 
extracted ; but one was to have recourse to cauterization and to mastica- 
tories, intended the one and the other to dissipate the accumulation of 
pituita, believed by him to be the cause of toothache. 

It is easily to be understood that as only loose teeth were to be ex- 
tracted, Hippocrates considered the extraction of teeth a very easy opera- 

* The use of carbonate of lime or chalk as a dentifrice evidently goes back to antiquity. 

* Unwashed woo! — that is, wool not cleansed of the fat secreted by the skins of the animals 
from whom it is taken — was much in use by the doaors of antiquity. One now obtains 
lanolin from it. 

* The obole was about three-quarters of a gram. 

* The cotyle was a little more than a quarter of a liter. • Page 507. 



tion, notwithstanding that the instruments then in use cannot have been 
other than very imperfect; and this is clearly to be seen from a passage 
in the book entitled De medico, where, after having spoken of the articles 
and instruments that ought to be kept in a doctor's office (officina medici), 
he adds: 

"These are the instruments necessary to the doctor's operating room 
and in the handling of which the disciple should be exercised; as to the 
pincers for pulling out teeth, anyone can handle them, because evidently 
the manner in which they are to be used is simple." ' 

Having made mention of the officina medici, we think it opportune 
to explain here with some precision what is to be understood by this term,' 
Medicine and surgery were practised in ancient times in open shops; 
this was so in Greece, and later also in Rome. When the practice of 

Very ancient dental forceps and two other dental (?) instruments existing in the 
Archxologtcal Museum of Athens. 

medicine became secularized through its abandoning the ^sculapian 
temples, doctors' shops began to arise in the most important centres of 
population, to which those in need of assistance resorted or were carried. 
In time these stations for the practice of medicine, and particularly of 
surgery, became more and more numerous. 

The Hippocratic collection contains a special treatise (De officina 
medici), which speaks of the conditions these places were expected to 
fulfil, the articles therein to be contained, the instruments, the general 
rules relative to operations, the bandages, etc. 

About six hundred years later, Galen wrote three books of commen- 
taries on this treatise of Hippocrates, He says, among other things. 

' Page II. 

' See Daremberg, Dictionnaire dcs Antiqui 

s Greques et Romaines, article "Chirurgie." 


that the doctor's shop ought to be spacious and furnished with wide 
openings, to let in abundance of light. These medical stations to which 
the sick and infirm repaired in great numbers to ask advice, to undergo 
operations, or receive medical dressings, must have been of great import- 
ance, as is to be presumed from the cited books of Hippocrates and Galen. 

The greatest doctors of antiquity practised the medical art in these 
places. It is also said that the great philosopher and naturalist, Aristotle, 
who came of a race of doctors, had inherited a doctor's shop of great 
value, but that notwithstanding this he refused to dedicate himself to 
the medical profession. 

The doctors' shops were at the same time real pharmacies, where 
doctors prepared medicines, and where all the remedies then in use, 
either simple or compounded, were kept and sold to the public. Besides, 
there were to be found instruments of every kind and articles for medi- 
cating; and, therefore, bandages, compresses, lint, sponges, cupping 
glasses, cauteries, knives, bistouries, lancets, sounds, needles, hooks, 
pincers, files, saws, scrapers, splints, appliances for replacement of 
luxated bones, speculums, trepans, apparatus for fumigation, trusses, 
and a thousand things besides. 

Naturally, dentistry was also practised in these shops, either by doctors 
who occupied themselves with dental maladies as with those of any other 
part of the body, or, later on, by individuals who dedicated themselves 
exclusively to this specialty. 

Medicine and surgery were exercised, however, not only in doctors' 
shops, but also at the patients' houses, and it was Hippocrates who 
especially inaugurated clinical medicine — that is, the practice of visiting 
patients in their beds. 

But we must not digress from our argument. 

Many observations relative to the teeth are to be found in the seven 
books of Hippocrates on Epidemics, Unfortunately, the observations are 
not always given in clear and precise terms, which principally depends 
on the fact that these books consist for the most part of simple and most 
concise notes, written by Hippocrates on cases observed by him, and not 
intended for publication under such form, but rather constituting the 
material for further work. 

Here is a passage from the fourth book on Epidemics^ which reveals 
Hippocrates' extraordinary power of observation, for even teeth that had 
fallen out were minutely examined by him, to the end of acquiring 
precise ideas on the anatomical conformation of these organs, held by 
him to be of the highest importance. 

"In the youth suffering from a phagedenic affection in the mouth, 
the lower teeth fell out, as well as the front upper ones, which left a 
cavity in the bone. The loss of a bone in the roof of the mouth causes 


depression in the middle of the nose; the falling out of the upper front teeth 
sometimes causes a flattening of the point of the nose. The fifth teeth 
counting from the front ones had four roots (two of which were almost 
united to the two contiguous teeth), the points of which were all turned 
inward. Suppurations arising from the third tooth are more frequent 
than from any of the others; and the dense discharge from the nose and 
pains in the temples are specially owing to it. This tooth is more apt 
to decay than the others ; but the fifth does so, as well. This tooth had 
a tubercle in the middle and two in the front; a small tubercle in the 
internal part, on the side of the other two, had first begun to decay. ^ 
The seventh tooth had only one large, sharp-pointed root. In the 
Athenian boy, there was pain in a lower tooth on the left, and in an 
upper one on the right. When the pain ceased, there was suppuration 
of the right ear." 

This last fact — of the suppuration of the ear — is mentioned by Hip- 
pocrates not as a simple coincidence, but as a fact intimately connected 
with the cessation of the toothache. This may be argued from the general 
ideas of Hippocrates in regard to the beginning and the resolution of 
diseases. He considers a malady to be produced by a humor, which 
becomes localized in a given point of the body. The crisis gives exit 
to the peccant humor,^ and the mode in which this is evacuated consti- 
tutes the critical phenomenon; the same may be represented either by 
a profuse perspiration, by abundant urine, by diarrhea, by vomiting, by 
expectoration, by bleeding or discharge of other humors from the nose, 
by the issuing of pus from the ear, and even by deposits on the teeth.' 
If by eflPect of organic sympathies the morbid humor, instead of being 
thrown outward, be transported into another region of the body, this 
constitutes the so-called metastasis. 

The hints just given will serve to render some of the passages which we 
quote from the works of Hippocrates more intelligible. 

In the fourth book on Epidemics we find among other clinical cases the 

" Egesistratus had a suppuration near the eye. An abscess manifested 
itself near the last tooth; the eye directly got quite well; there was a 
dense discharge of pus from the nostrils; and small, rounded pieces of 
flesh were detached from the gums. It seemed as though a suppuration 
at the third tooth were going to take place, but it went back; and suddenly 
the jaw and the eye swelled up."* 

And farther on one reads: 

* The various editions here offer numerous variations, but the sense is ever)'where obscure. 

* See Bouillet, Precis d'Histoire de la Medecine, p. 94. 

* On Epidemics, lib. ii, section i, p. 1002. 
^ De morbis vulgaribus, lib. iv, p. 1131. 


"In Egesistratus the two last teeth were decayed in the parts where 
they touched one another. The last had two tuberosities above the gum, 
one on the decayed side, the other on the opposite side. In the part in 
which the two teeth were in contact with one another there were two 
roots in each, large and similar, and corresponding to those of the con- 
tiguous tooth; on the other side there was only a half root^ and rounded." 

Toward the end of the fourth book on EpidemicSy we find repeated an 
observation which we have already noted: 

"The third upper tooth is found to be decayed more frequently than 
all the others. Sometimes a suppuration is produced all around it."^ 

In the following passage mention is made of a mouth wash against 
toothache, the basis of which is castoreum and pepper: 

" In consequence of a violent toothache the wife of Aspasius had her 
cheeks swollen up; but on making use of a mouth wash of castoreum and 
pepper she found great relief."^ 

A little after we find the practice of bleeding mentioned; and contem- 
porarily an allusion to the use of alum — with regard to a painful swelling 
of the gums, that is to say, a gingivitis: 

"Melisandrus suffered severe pain and swelling of the gums; he was 
bled in the arm. Egyptian alum, if used in this malady, arrests its 

Toward the commencement of the sixth book the following observa- 
tion is registered: 

"Among those individuals whose heads are long-shaped, some have 
thick necks, strong members and bones; others have strongly arched 
palates, their teeth are disposed irregularly, crowding one on the other, 
and they are molested by headache and otorrhea."* 

While we should be tempted to attribute the knowledge of the relations 
between malformation of the skull, ogival palate, and bad arrangement 
of the teeth to quite modern studies, we are obliged to admit, and to our 
great surprise, that these relations were already noted, twenty-four 
centuries back, by the great physician of Cos. 

In the seventh book on Epidemics^ a case of scorbutus is described, 
where incense and a decoction of lentils proved useful against the lesions 
of the buccal cavity: 

"... Large tubercles, of the size of grapes, had formed on 
the gums close to the teeth, black and livid, but not painful, except 
when the patient took food. For the mouth, incense powder mixed 
with some other ingredients proved useful. The internal use of the 
decoction of lentils also did good to the ulcers of the mouth."' 

* That is a very short root. * Page 1138. 
' De morbis vulgaribus, h'b. v, p. 11 57. * Page 1157. 

* De morbis vulgaribus, lib. vi, section i, p. 1164. * Ibid., vii, p. 1223. 


In the same book there is a passage in which Hippocrates warns against 
the use of origanum, as harmful to the teeth and eyes: 

"Origanum in drinks is harmful to affections of the eyes, and also 
to the teeth. "^ 

Farther on a case of necrosis of the jaw is mentioned: 

" Cardias, the son of Metrodorus, by reason of pains in the teeth was 
subject to mortification of the jaw. Excrescences of a fleshy kind formed 
on the gums, that grew most rapidly; the suppuration was moderate; 
the molars fell out and afterward the jaw itself."^ 

Some passages in the Epidemicsy^ and in other books of Hippocrates, 
even when not referring directly to pathological conditions of the teeth, 
are of value as demonstrating what importance the author attaches to 
the dental organs, and to the phenomena of which they may possibly 
become the site. 

In establishing the diagnosis of a malady, he recommends searching 
for its point of departure; for example, if it has begun with a headache, 
an earache, a pain in the side, and adds, that in some cases the nature 
of the malady is revealed by the teeth, in some others by swelling of 
the glands.* The truth and importance of this observation are not to 
be doubted. 

In fevers, Hippocrates considers it an unfavorable sign if there be a 
deposit of viscous matter on the teeth, especially when the patient keeps 
his mouth half open, that is, when he lies in a state of stupor.* 

Other prognostics drawn from the teeth or the gums are the following: 

"Grinding of the teeth in those who have not this habit when in full 
health, gives reason to fear a furious delirium and death; but if the 
patient, already delirious, presents this sign, it is an absolutely fatal one." 
It is also a most unfavorable sign when the teeth get very dry." 

"Necrosis of a tooth heals the abscess formed at the gum.^ This 
is very easily explained by the fall of the tooth. But Hippocrates knew 
very well that the aflFection does not always take such a favorable course; 
he therefore adds, immediately after: 

" In the case of necrosis of a tooth the supervening of a strong fever 
with delirium gives reason to fear a fatal exit. If, notwithstanding this, 

* Page 1229. ' De morbis vulgaribus, lib. vii, p. 1238. 

' The title of these seven books of Hippocrates might cause a false idea to be conceived. 
They do not precisely treat of epidemics in the sense given to the word in the present day; 
instead, they describe the maladies which predominated during four years, in successive 
periods of time, according with the variations of the atmospheric conditions. (See Litre, 
Introduction to the books on Epidemics.) 

* De morbis vulgaribus, lib. iii, p. 1009; lib. vi, section iii, p. 1 176. 

* De morbis vulgaribus lib. iv, p. 1138 ; Aphorisms, lib. iv. No. 53, p. 1251. 

* Coacae prai^notiones, No. 235, p. 157 ; Praedictorum, lib. i. No. 48, p. 71. 
^ Coacse pracnotiones, No. 236; p. 157. 



the patient be saved, there will be suppuration and exfoliation of the 

According to Hippocrates, "violent pains in the lower jaw give reason 
to fear a necrosis of the bone."^ 

"Gingival hemorrhage in cases of persistent diarrhea is an unfavor- 
able symptom."' In fact, the easy and frequent occurring of hemor- 
rhage of the gums may, in many cases, be an indication of profound 
alteration of the blood, a condition serious in itself, but still more so when 
associated with obstinate diarrhea. 

In different parts of the books of Hippocrates, the influence of atmos- 
pheric conditions on the production of dental and gingival maladies is 
alluded to. 

" Much inconvenience was caused to various persons at that period of 
time by swelling of the fauces, by inflammation of the tongue, by abscesses 
of the gums."* 

"After the snow, there were west winds and light rains; colds in the 
head, with or without fever, were very frequent; in one of the patients, 
pains were produced in the teeth on the right side, and in the eye and 

In more than one of his books Hippocrates speaks of special dental 
or gingival symptoms, having their origin in diflFerent maladies, especially 
those of the spleen : 

"In many who have enlargement of the spleen the gums become 
aflFected and the mouth has a bad smell."' 

In another place we read: 

"Among those persons who have an enlargement of the spleen, the 
bilious ones have a bad color, are subject to ulcerations of a bad nature, 
their breath is fetid, and they themselves are thin."^ Finally, in the 
Book on Internal Diseases, Hippocrates describes diflFerent species of 
splenic maladies, to one of which he assigns the following symptoms: 

"The belly becomes swollen, the spleen enlarged and hard, the patient 
suflFers acute pain in it. The complexion of the individual is altered. 
A bad smell emanates from the ears. The gums are detached from the 
teeth and smell bad; the limbs wither, etc."* 

The cases of splenic swellings spoken of by Hippocrates in the above 
passages must have been owing, without doubt, to grave cachectic condi- 
tions (among which, probably, scurvy); and we know that gingivitis, 
with all its possible consequences (among which expulsive periodontitis), 

* Loc. cit., No. 237. 

^ Loc. cit., No. 241, p. 157; No. 648, p. 222. 

* De morbis vulgaribus, lib. iii, p. 1083. 

* Prxdictorum, lib. ii, p. ill. 

' De intemis affectionibus, p. 549. 

' Loc. cit., No. 239. 

*Ibid., lib. iv, p. 1121. 
^ De affeaionibus, p. 521 


is not only a constant symptom in scurvy, but is also frequent in all dis- 
eases attended by profound disorders of nutrition.^ 

Setting on edge of the teeth is counted by Hippocrates among the many 
symptoms to which a protracted leucorrhea may give rise: 

"One should ask women who have been troubled for some time with 
a white flux whether they suflFer from headache, pains in the kidneys and in 
the lower part of the belly, as well as setting on edge of the teeth, dimming 
of the sight, singing in the ears."^ 

Hippocrates had also observed that the phenomenon of setting the 
teeth on edge {stupor dentium) may be produced as well by acids in 
general, also by acid vomiting;' and that it may also be produced in many 
individuals by a strident sound.* 

In the second book oi Epidemics we find a proposition of the following 

"Long-lived individuals have a greater number of teeth;"* which is 
as much as to say that "the having a greater number of teeth is a sign 
of longevity." This prejudice is to be found repeated by many authors 
subsequent to the epoch of Hippocrates, and among these by Aristotle 
and Pliny. Not even the greatest men are infallible; there is, there- 
fore, no reason to be scandalized if Hippocrates should really have fallen 
into such an error. Anyhow, it should be observed that only the first 
and the third book on Epidemics are held to be really authentic, 
while the other five were probably compiled by other doctors of the 
school of Hippocrates who did not limit themselves merely to gathering 
together the many isolated notes and observations left in writing or derived 
from the oral teachings of their master, but took it upon themselves to 
introduce into the compilation something of their own besides. It is, 
therefore, anything but certain that the above-mentioned error is really 
to be attributed to Hippocrates. 

The probable origin of this prejudice, which certainly originated among 
the people and was afterward accepted by the doctors, is easily to be 
guessed at. Individuals blessed with dental arches of remarkable 
beauty and perfection may sometimes convey the impression of having a 
greater number of teeth than others, for those two rows of regular white 
teeth, close to one another, strike the optic sense much more vividly 
than teeth of the ordinary kind. This impression is somewhat analogous, 
at least as regards color — to the optical illusion which causes a white circle 
to appear larger than a black one of equal diameter. Now, without 
doubt, individuals with a perfect denture are mostly healthy and well 

* Paul Dubois, Aide-memoire du chirurgien-dentiste, Paris, 1894, 2me partie, pp. 415, 

^ Prsedictorum, lib. ii, p. 108. ' De internis affectionibus, p. 534. 

* De humoribus, p. 49. * De morbis vulgaribus, lib. ii, section vi, p. 1050. 


constituted, and, therefore, live longer, in general, than others. It is 
also to be noted that these people usually keep all their teeth to a more 
or less advanced age; and there is no doubt that among adults of the same 
age, those who have a less number of teeth, by reason of having lost 
several of them, are, in general, individuals whose organic constitutions 
are less good, whose health is less satisfactory, and who are, therefore, 
destined in all probability to live a shorter time than the others. It is, 
therefore, perfectly true, but only in a certain and very limited sense that 
"long-lived individuals have a greater number of teeth." 

Geist-Jacobi, perhaps in order to dissipate the erroneous significa- 
tion of the Hippocratic proposition cited above and to place in evidence 
that part of it which may be true, has thought well to translate it thus: 

"He who lives long keeps many teeth." But this translation does not 
render faithfully the idea expressed in the original Greek, ol fia-jK^fjofim Ttheofji; 
odouTo^ liouatv (literally, the long-lived have more teeth); a proposition 
that the most celebrated commentators of Hippocrates interpret in the 
sense given by us, and which Litre translates excellently well in these 
words: ^^ Avoir des dents en plus grand nombre est un signe de longevite/' 

Notwithstanding this prejudice, which survived vigorously for many 
centuries, the regular number of teeth was not unknown at the time of 
Hippocrates. This is to be perceived from a brief treatise of the Hippo- 
cratic collection, entitled De hominis structural wherein is written: 

"The teeth, together with the molars, are thirty-two." 

Among the many and many counsels of practical value registered in 
the works of Hippocrates, the following deserves special mention : 

" When a person has an ulcer of long duration on the margin of the 
tongue, one should examine the teeth on that side, to see if some one of 
them does not, by chance, present a sharp point."* 

In fact, it not infrequently occurs that a lingual ulcer deriving from 
irritation produced by a broken or sharp tooth assumes a malignant 
aspect that causes it to be mistaken for a cancerous ulcer, and medical 
men may even be so far misled as to advise the extreme remedy of 
amputation of the tongue. If, however, the consulting surgeon has some 
experience, he will not neglect in the first place to examine accurately 
the state of the patient's teeth ; it then mostly happens that after the 
removal of the offending tooth a complete cure is obtained in a brief 
space of time. How much anxiety would not such poor sufferers be 
spared if physicians in general were acquainted with the counsel given 
by Hippocrates twenty-four centuries ago! 

In speaking of fracture of the lower jaw, Hippocrates recommends 
binding the teeth next to the lesion together. He distinguishes between 

* Prafdictorum, lib. ii, p. 96. 

^H 60 FIRST ^f^^^^^t 

^^M the complete and the incomplete fracture; he then speaks separately ^^M 
^H of the fracture of the symphysis. Treating of the incomplete fracture, ^H 
^V he ^H 
^M "If the teeth in proximity of the lesion be shaken, one ought, after ^H 
^H having reduced the fracture, to bind them one to the other, until the ^H 
^^^ consolidation of the bone, using preferably gold wire for the purpose; ^^M 
^H but if this be wanting, linen thread can be used instead, and not only ^| 
^^1 ought the two teeth next to the site of the fracture to be bound, but ^^^^^H 
^H several of the others besides.'" ^^^^^M 

^H 9 ^^^^1 



Kflili] IB 


^^F Two Greek appliances existing in the Archsological Museum of Athens. ^H 

^H Farther on, when speaking of complete fractures, he renews this advice ^H 
^H In these words: ^H 
^H "After having carried out the coaptation, the teeth ought, as we have ^H 
^H said already, to be bound one to the other; this greatly contributes ^H 
^H to obtaining the immobility of the fragments, particularly if property ^H 
^H carried out."' ^H 
^H Also, in cases of fracture of the svmphvsis, Hippocrates recommends ^H 
^H "binding the teeth together on the right and left of the lesion." And ^H 
^H after having spoken of the best adapted means uf constraint in such ^H 
^H kinds of fractures, he adds: " If the reduction has been well performed, ^H 
^H and the part kept in proper repose, the consolidation takes place in a short ^H 
^^B time and the reeth do not undergo any damage; in the contrary case, the ^^^^H 

^^^B ' De articulis, p. ' Loc. cit. ^^^^^^^ 



cure is retarded, the fragments reunite in a bad position, and the teeth 
are injured and become useless."^ 

From what we have referred, it is easy to perceive how much impor- 
tance Hippocrates attached to the dental system, what knowledge he 
possessed as to the pathological conditions of the teeth, the gums, and 
the jaws, and what means of treatment he used. But in what relates 
to therapy it will perhaps not be useless to make some further obser- 

One of Hippocrates' aphorisms says: 

" Cold is the enemy of the bones, the teeth, the nerves, the brain, and 
the spinal marrow."' 

From this it is easy to conclude that Hippocrates was no friend to 
hydrotherapic treatment, and that he considered the use of cold drinks 
bad for the teeth, and cold applications harmful in dental diseases. 

The idea expressed in the aphorism just quoted is to be found repeated 
in the book entitled On the Use of Liquids;^ and in this same treatise we 
find vinegar recommended shortly after in cases of burning of the teeth 
(an expression probably meant to indicate those pathological conditions 
of the teeth and gums which are accompanied by a sense of burning). 

Some of the Hippocratic maxims, full of wisdom and good sense, will 
forever conserve their importance, whatever be the degree of perfection 
to which medical science may come. 

"Diseases, says he, should be combated in their origin;"* which is as 
much as to say, that it is not enough to apply symptomatic or palliative 
means of cure, but that it is necessary, rather to seek and to combat the 
true causes of disease. And in another place we find written: 

" One should take care of two things in illnesses — to do good and not 
to do harm. The art of curing includes three terms: the malady, the 
patient, and the doctor. The latter is the minister of the art; the patient 
has to combat the malady together with him."* 

It is only too true, that not all the representatives of the healing art 
keep sufficiently in view the precept to do good and not to do harm; nor 
do all patients comport themselves in such a manner as to contribute, in 
accordance with Hippocrates' wise counsel, to the work of their own cure. 

Aristotle, the greatest philosopher of antiquity, was born at Stagira, 
in Macedonia, and lived from 384 to 322 B.C. He wrote most excellent 
works on all branches of human knowledge, and was the founder of 
Natural History and Comparative Anatomy. His acquaintance with 
anatomy as illustrated principally in his treatise On the Different Parts 
of Animalsy is absolutely extraordinary for the time in which he lived. 

* De articulis, p. 800. 

' De liquidorum usu, p. 426. 

* De morbis vulgaribus, lib. i, p. 948. 

* Aphorism, lib. v, No. 18, p. 1253. 
^ De locis in homine, p. 419. 

Iff' Ults^r nRlOD-ANTIQUITr 

\\)\ sM^^V4 v^ lhi>i work* ij* altogether dedicated to the study of the 
KViKt Km^ Kv ♦Uxo x|H*ak« of these organs in many other of his works, 
|.v«4U4v^Kul\ iu hU History uf Auimals^ which is a real and proper treatise 
v^u A^v^v^w whi^ivin thr author records a great number of notes about 
ihv ^H'vuii«uiiivM (MVM'iUril by the dental system, in the different classes 

\\\ %(iuv of \\w gu^ar rrrorN into which he has fallen, his ideas about 
\\\y is'vlh *4iVi U\\k\'\\ aM a whole, quite worthy of attention, especially 
\\\\\\\ Ky\w soumidnw ihr remote epoch in which this great philosopher 
v\u»lv \N\^ will luMr give a brief notice of the most important of his 
ubmv»uioUii ubuiutt «» the dental organs. 

I \w l(Miu, [\w dimpoMiiion, the number of the teeth, varies in animals, 
anohllMu Ui [\w (jualiiv of their food and according to whether the teeth 
kKWK \\w\sA\ In diviile and to chew the alimentary substances, or as 
(U^UMliUMMti ol dlliHU'i' and defence as well. In man, the teeth serve 
\\\[\\\ \yA\\ loi MiamlicatioM, but the front ones have, besides, another most 
liMlMMIMlM olhus lunnelv, that of aNNisting in the articulation of words, 
li) \\w |Mniuih( liMMiM or certain letterw. 

li) (hMM« aniiHfiU in which the teeth also serve as weapons, it is to be 
nhmiMd sA\\w\ that Mime of them protrude like those of the boar, 
iM llhtl llu<v au> nhaip and Naw-like in their disposition, as in the lion, 
I hi' htMMluM, llu^ d<i(ii etc. No animal possesses at the same time pro- 
MMillMU (Mhl naw likr lerth. 

I hi' \v\^\\\ air Mill alwavM e(|ual in number in both jaws; the animals 
MmUiIi'iI Willi liiMiu have no teeth in the front of the upper jaw; this, 
linm u-li h iiImi III he obMeived in animals without horns, as for example, 
III llii* I iiliii'l Ainniid the animals provided with horns there are none 
^Jihli liiiM» |iiMtniding ni waw-like teeth. 

Ill yi'lii«liil» th«' hnlU lerfh are pointed and the back ones broad. Never- 
llii liMM, iill ihr imh oC the weal are pointed, with a saw-like disposition, 
|iiihti|i>i lMuiii*ir thiN animal marks the transition from the quadruped 
IM ihi' liMh, III! nl which, with few exceptions, have their teeth formed in 
ihiil Wii\ AmimmIn with saw-like teeth have generally very large mouths. 

Nil h.iN rvrr more than one row of teeth in each jaw; however, 
mi\M Aii»it<»tlr, il C'trsias^ is to be believed, there is an animal in India, 
ihiinrd iniirticdra, which has a triple row of teeth. 

Ihc molar teeth are never changed either in man or in any known 
jtiinwil; the pig never changes its teeth. 

( )nr t ;iii judge the age of many animals by their teeth. As the animal 

' Or piirtthus animalium, lib. iii, cap. i. 

' Ocsia.s, of C'nydus, wrote various works, somewhat earlier than Aristotle; one of which, 
fhr History of India, is very interesting, but also contains not a few fables. 


grows older, the teeth become darker in color, except in the case of the 
horse, whose teeth grow whiter with age. 

The last molars are cut by men and women about the twentieth year; 
but in some cases, and especially with women, they have been known 
to come forth — not without pain — very much later, even so late as at 
eighty years of age. 

The man has more teeth than the woman; this peculiarity is also to 
be found in the female of some animals (such as sheep, goats, and pigs). 

Individuals provided with many teeth generally live the longest, those 
instead who have fewer teeth (or simply far apart) are generally shorter 

The teeth are generated by the nourishment distributed in the jaw- 
bone; they are, in consequence, of the same nature as bones. Their 
surface, however, is very much harder than that of the bones. The teeth, 
contrarily to all other bones, grow throughout life, so as to provide for 
their wearing away through mastication; and for this reason they lengthen 
when the antagonizing teeth are wanting. - 

The teeth differ from all the other bones, therein that they are generated 
after the body has been already constituted; they are, therefore, secondary 
formations; and precisely for this reason are able to be shed and to be 

Some of the veins of the head, says Aristotle, terminate with very 
slender branches inside the teeth.^ 

The dental system of the monkey is altogether similar to that of man. 

The molar teeth exist in viviparous quadrupeds as well as in man; 
in the oviparous quadrupeds and in fish they are wanting. They serve 
to grind food, a function in which the lateral movements of the inferior 
jaw have, in many animals, a large share. For this reason, in animals 
who have no molars, these lateral movements do not exist. 

In birds, the beak takes the place of the lips and teeth; the substance 
of which it is formed is similar to that of the horn or the nails. 

In those animals which, instead of having all the teeth sharp, are 
furnished with incisors, canines, and molars, these three species of teeth 
are disposed in the same order as in man. 

The setting on edge of the teeth may be produced not only by eating 
acid things, but also simply by seeing them eaten. This sensation may 
be made to cease by the use of purslane and salt. 

* This, as well as other errors of Aristotle, we shall Bnd repeated throughout the lapse 
of centuries by many authors, Galen not excluded, who, in fact, by the authority of his name, 
gave them valid confirmation. 

' The distinction between arteries and veins was, at that time, not yet well known, though 
we already Bnd, in this passage of Aristotle, allusion made to the relations between the teeth 
and the bloodvessels. 


In the book entitled Problems^ many of which have reference to medical 
matters, one is to be found to the following effect: 

"Why do figs, when they are soft and sweet, produce damage to the 
teeth ?" Perhaps, answers Aristotle, because the viscous softness of 
the fig causes small particles of its pulp to adhere to the gums and in- 
sinuate themselves into the dental interstices, where they very easily 
become the cause of putrefactive processes. But, he adds, it may also 
be that harm is produced to the teeth by masticating the small hard 
grains of this fruit. 

In Aristotle's Mechanics^ the following question relative to the extrac- 
tion of the teeth is discussed: 

"Why do doctors extract teeth more easily by adding the weight of 
the odontagra (dental forceps) than by using the hand only.? Can it 
be said that this occurs because the tooth escapes from the hand more 
easily than from the forceps .? Ought not the irons to slip off the tooth 
more easily than the fingers, whose tips being soft can be applied around 
about the tooth much better.? The dental forceps," adds Aristotle, "is 
formed by two levers, acting in contrary sense and having a single fulcrum 
represented by the commissure of the instrument. By means of this 
double lever it is much easier to move the tooth, but after having moved 
it, it is easier to extract it with the hand than with the instrument." 

From this passage of Aristotle one may draw various conclusions. 
First of all, it appears that, at that time, the extraction of teeth was a 
common enough operation carried out by doctors in general, or, at least, 
by specialists not indicated by any particular denomination but called 
doctors (in Greek, carpoc) just the same as those who dealt with the 
maladies of every other part of the body. If, therefore (which, however, 
is very doubtful), there existed in Greece, as there certainly did in Egypt, 
individuals who occupied themselves exclusively with the treatment of 
the teeth, they cannot have formed a distinct class of professionals, but 
merely a section of the medical class. Herodotus, too, as we have already 
seen, does not say, speaking of Egypt, that there was a proper class of 
dentists, but gives us to understand that the Egyptian doctors did not 
occupy themselves indiscriminately with the treatment of all maladies, 
for some dedicated themselves to curing the eyes, others to the treatment 
of maladies of the head, others to those of the teeth, and so on. 

From the Aristotelian passage on the extraction of teeth, just quoted, 
it may be concluded that in those times the Hippocratic precept, that 
only loose teeth were to be extracted, was not observed, for otherwise, 
Aristotle could not have said that dental forceps are useful to loosen the 
teeth, but that after this has been done the extraction of the tooth may be 
more easily effected by means of the fingers than with the instrument. 

This last assertion appears very strange. It demonstrates that either 


the instruments then in use were very imperfect, or that Aristotle, although 
the son of a doctor and himself possessed of vast medical knowledge, 
had absolutely no experience as to the extraction of teeth; and, therefore, 
speaking theoretically, and without any practical basis, he ran into error, 
as even the greatest men are apt to do when drawing conclusions from 
purely theoretical reasonings. 

From Aristotle to Galen, that is, for the space of five centuries, the 
anatomy of the dental system, so far as may be deduced from the writings 
preserved to us, made no sensible progress. But in respect to this, one 
must take into consideration some historical facts of capital impor- 
tance. The school of medicine of Alexandria, which arose about three 
centuries before Christ, numbered among its most brilliant luminaries 
the celebrated doctors Herophilus and Erasistratus, who were the initia- 
tors of the dissection of human corpses,* thus giving a great impulse 
to anatomical research. It is, therefore, hardly admissible that these 
two great anatomists, who studied with profound attention even the most 
complicated internal organs, should have neglected the anatomy of the 
teeth. Unfortunately, however, not all the results of their researches 
have come down to us; nor is this to be wondered at, especially if we 
reflect on the large number of precious works entirely lost by the destruc- 
tion of the celebrated library of Alexandria, a.d. 642. 

When we come to speak of Archigenes, we shall see how he, in certain 
cases, advised trepanning the teeth. This would lead to the belief that 
in his times, viz., toward the end of the first century after Christ, the exist- 
ence of the central cavity of the tooth was not ignored, and that, there- 
fore, the structure of these organs had already been the object of study. 

As to diseases of the teeth and their treatment, there is no doubt that 
Herophilus and Erasistratus must have occupied themselves with these 
subjects; and the same may be asserted of Heraclides of Tarentum, a 
celebrated doctor who lived in the third century before the Christian era. 
Indeed, we read in Coelius Aurelianus,^ that the record had come down 
through the works of Herophilus and Heraclides of Tarentum, of persons 
having died by the extraction of a tooth.' The same writer also alludes to 
a passage of Erasistratus, relating to the odontagogon already mentioned, 
which was exhibited in the temple of Apollo, and to the practical signifi- 

* According to the testimony of Celsus, a very serious author and in every way worthy of 
belief, Herophilus and Erasistratus dissected not only corpses, but also living men, namely, 
malefactors consigned to them by the kings of Egypt, in order that they might make re- 
searches into the normal conditions of the organs during life, and their mode of functioning. 
See Cornel. Cels., De re medica, lib. i. Preface. 

' Coelii Aureliani de morbis acutis et chronicis, lib. viii, Amstelaedami, 1755> Pars ii, lib. 
ii, cap. iv, De dolore dentium. 

* Herophilus et Heraclides Tarentinus mori quosdam detractione dentis memoraverunt. 



cation to be attributed to the fact of this instrument being of lead and 
not of hard metal. Now, if Herophilus, Heraclides of Tarentum, and 
Erasistratus all spoke of the serious peril to which the extraction of a 
tooth may give rise, and therefore recommended not having recourse to 
it too lightly, it is evident that they had given serious attention to this 
operation and consequently also to the morbid conditions that may 
render it necessary. 



Much earlier than the foundation of Rome (b.c. 753) there flourished 
in that part of Middle Italy today called Tuscany the highly civilized 
people known by the name of Etruscans or Toschi. Their political 
organization had the form of a confederation of twelve principal cities/ 
the federal capital being Tarquinii. The Etruscan people were indus- 
trious, intelligent, and artistic in the highest degree, possessing special 
skill in the decorative arts, splendid monuments, some of which still remain 
to us; they were fond of luxury in all its manifestations, and took great 
care of their persons; at the same time, however, they were a laborious 
and courageous race, not only most active and enterprising in agri- 
culture, in art and commerce, but also brave warriors and hardy 

In their long sea voyages the Etruscans frequently visited Egypt and 
Phoenicia, trading especially in the more flourishing cities, which were 
at that time Memphis in Egypt, and Tyre and Sidon in Phoenicia. On 
the other hand, the Phoenicians, who were also active merchants and 
navigators, not only visited Etruria and other regions of Italy very 
frequently, but also established numerous colonies in many islands of 
the Mediterranean, and especially in those nearer to Italy. 

This continual intercourse between Etruscans, on the one side, and 
Egyptians and Phoenicians, on the other, accounts for the great influence 
exercised by the Egyptian and Phoenician civilization upon the later 
developed Etruscan culture — an influence manifesting itself very distinctly 
in the works of art of the latter, which often have an altogether Oriental 
character, and not seldom represent scenes drawn from the domestic life 
of the Egyptians and Phoenicians.' 

As to what concerns dental art, everything leads up to the belief that 
it was practised by the Egyptians and Phoenicians earlier than by the 
Etruscans, whose civilization, as already hinted, is certainly less ancient. 
Nevertheless, in comparing the dental appliances found in the Etruscan 
tombs with the sole authentic dental appliance of Phoenician work- 

» Arretium, Caere, Clusium, Cortona, Faesulae, Falerii, Pisar, Russcllae, Tarquinii, Vetulonia, 
Volaterrae, Volsinii. 

' DenefFe, La prothese dentaire dans Fantiquite, p. 51* 


manship known at the present day,' we cannot but be struck with the 
great superiority of" the Etruscan appliances. It is therefore probable 

' Dr. a^rand in li[& book The- Rise. Full, and Kcviv;il of Dentil Prosrhcsis, after having 
spoken of the Phurnician denral appliance described in Kenan's work, adds; "There are 
scores of specimens of Phccnician denial an in home collcciiunii and also ar the Columbian 
World's Fair." However, uniil these specimens of Phoenician denial art are described and 
their origin is exactly known, their auihenticit)' will always remain a matter of doubt. 
[Cigrand is in error. The specimens he speaks of wet« mainly imanined.— W. H. Tri'EMan. ] 


that the Etruscans, although they had learned the dental art from the 
Egyptians and Phoenicians, had subsequently carried it to a much higher 
degree of perfection than it had arrived at in Egypt or in Phoenicia. An 
analogous fact has come to pass in our own times. Dental art in 
America, which emanated from the French and English schools, soon 
took on so vigorous a development as indisputably to acquire first rank. 

Before describing in detail the dental appliances found up to now in 
Etruscan tombs, we will consider a question touching very closely upon 
the argument which we are treating and which has already been discussed 
in Professor Deneffe's book, already cited. 

How is it that the dental appliances of the Phoenicians, Greeks, 
Etruscans, and Romans should have come down to us, notwithstanding 
cremation .? 

In the first place, if one reflects that the teeth offer an altogether special 
resistance to the action of fire, and if one also remembers that gold was the 
substance employed for the construction of the appliances in question, 
and that this metal does not melt save at a very high temperature, it no 
longer appears marvellous if, in many cases at least, the dental appliances 
should have been able to resist the cremating process. 

In the second place, the cremation may possibly sometimes have been 
incomplete — that is to say, the skeleton may not have been altogether 
reduced to ashes; therefore, among the residuum of this incomplete com- 
bustion, a piece of a jaw may easily have remained, and incidentally 
also its prosthetic appliance. 

But besides all this, it must be considered that the custom of burning 
corpses was not at all general among ancient people. Indeed, cremation 
was not in use either among the Egyptians, the Phoenicians, the Hebrews, 
or the Chinese; the Greeks only resorted to it in exceptional cases. The 
most ancient tombs of the Etruscans show that at the epoch of their 
settling in Italy, cremation was in general use among them. But little 
by little, as they entered into commercial relations with the Egyptian, 
the Phoenician, and the Greek peoples, who did not burn their dead, the 
custom of burial substituted that of cremation. Toward the end of the 
sixth century before Christ there were to be found in southern Etruria, 
one beside the other, tombs for the burial of corpses and others for 

One sometimes finds in one and the same tomb a cinerarium (urn for 
conserving ashes) and skeletons enclosed in sarcophagi or resting on 
mortuary couches. 

At Tarquinii and Orvieto burial generally prevails. 

In the fifth century B.C., the epoch in which the Law of the Twelve 
Tables was promulgated, burial and cremation were equally in use 
among the Romans. In the second century of the Christian era burial 



was already prevalent, and through the influence of Christianity became 
general during the third and fourth centuries.^ 

Notwithstanding cremation, which certainly must have destroyed a 
great number of the dental appliances of that time, and in spite of the 
many diflferent destructive agents which successively did their work 
on those human remains during so many centuries, not a few prosthetic 

Fig. 13 

Fig. 14 

Tooth crowns found in an Etruscan 
tomb of the ancient Vitulonia (Archxological 
Museum of Florence). The enamel-cap- 
sules of these teeth (four molars and one 
canine) are perfectly well preserved, whilst 
the ivory has entirely disappeared. 

The same tooth-crowns of the preceding 
figure, seen from the side of the concavity 
of the enamel capsules. 

pieces of Etruscan workmanship have come down to us; from which we 
may argue that dental prosthesis was not an exceptional fact among 
this people, as some may perhaps suppose, but, on the contrary, must 
have been a very usual practice. 

The dental appliances discovered up to now among Etruscan remains 
are preserved in diflferent Italian museums, with the exception of some 
few existing in private collections or of others that have passed out of 
Italy into other countries. 

In the museum of Pope Julius in Rome there is a dental appliance 
found at Valsiarosa in one of the many Etruscan tombs excavated in that 
locality near Civita Castellana, the ancient Falerii (Fig. 15). This 

* DenefFe, op. cit., pp. 60, 61. 


appliance is formed by a series of four gold rings meant to encircle four 
teeth (canine, bicuspids, and first molar). The third ring is traversed by 
a pivot riveted at the two extremities, which was meant to hold fast an 
artificial tooth (the second bicuspid); this is wanting, however. One 
naturally puts the question, How is the disappearance of this tooth to 
be accounted for, it having been traversed by the pivot, which is still 
found in its place? The suppositions are two: Either the aniticial tooth 
was made of some not very durable material, which, in the course of time, 
became reduced to powder or fell to pieces, or may have been destroyed 
in some other way; or else the artificial tooth, instead of being simply 
perforated to allow the pivot to pass through, was cleft longitudinally at 
its base and, being introduced into the ring sat, so to speak, astride the 
pivot. In the second case, which, however, seems to me the less probable 
of the two, the tooth may merely have come off the pivot and gotten lost. 
In the Civic Museum of Cornefo, the ancient Tarquinit, there are 
two dental appliances, one of which (Figs. i6 and 17) is of the greatest 
interest. It was found in one of the most ancient tombs in the necropolis 
of Tarquinii. This specimen of prosthesis is formed of three teeth; 
the two upper central incisors and the second bicuspid on the left, which 
is no longer in existence. 

Fig. 15 


Etruscan appliance found at Valsiarosa, destined to support an artificial bicuspid, 
now disappeared. 

To afford support and maintain the three artificial teeth in position, 
the Etruscan dentist of about three thousand years ago, ingeniously 
made use of the canine and the lateral incisor on the right, the canine, 
the first bicuspid, and the first molar on the left, connecting them by a 
continuous series of pure gold rings soldered together. The dentist had 
not employed human teeth to replace the incisors which the individual 
had lost; according to the religious laws of the time, the dead were held 
sacred, and it would probably have been considered sacrilege to use their 
teeth; or it may also be that the patient had declared his aversion to the 
idea of substituting his own teeth by those of a dead man. However 
this may be, the Etruscan dentist thought well to repace the missing 
incisors with a somewhat large ox tooth; upon this he had made a groove, 
so as to give it the appearance of two teeth. In reality this ox tooth 
occupies the place not only of the two middle incisors, but also of the 
lateral incisor on the left. Perhaps by a natural anomaly the individual 



may never have had this tooth; or, more probably still, some length of 
time may have elapsed between the loss of one of the three and the other 
two, so that when he made up his mind to have recourse to a prosthetic 
appliance, the space normally occupied by the three incisors was already 
notably diminished, and the void could therefore be filled by an ox tooth 
so adjusted as to represent only two teeth. 

When I was intrusted with the reproduction of all the ancient pros- 
thetic pieces existing in the Italian museums, I met with special difficulty 
in the reproduction of the above-mentioned piece; and this because I 

could not succeed in procuring an ox tooth that was not worn away by 
the effects of mastication. The idea then occurred to me of sectioning 
the upper jaw of a calf at about the age of the second dentition, and 
taking out the teeth, which were already strong and well formed, but not 
yet deteriorated by mastication. I fancy my Etruscan colleague must 
have done the same three thousand years ago, when he carried out the 
prosthesis in question, for the large tooth employed by him does not 
show any signs of being worn by mastication. 

This large tooth is solidly fixed by means of two pivots to the gold band 



that encircles it. Another pivot served to fix the second bicuspid, also 
artificial. This tooth, as already stated, has now disappeared, but the 
pivot that fixed it to its ring is still in its place. In carrying out this 
prosthesis the dentist has contrived the series of rings that support the 
teeth in such a manner that they remained above the gum, and thus the 
harmful effects of contact and of the pressure of an extraneous body 
was avoided. At the same time, this arrangement, by distancing the 
rings from the dental neck that narrows off conically, added to the 
firmness of the prosthesis. 

Fig. i8 

Eltuscan appliance for supporting two inserted hui 

(Civic Museum of Cometo.) 

Another dental appliance (Fig. i8) which is in the custody of the 
Civic Museum of Corneto, was also found in a very old Etruscan 
tomb. It is formed by two bands of rolled gold; one of these is labial, 
the other lingual, and they are soldered together at their extremities, 
forming by the help of four partitions, also of gold, five square spaces. 
Three of these served for the reception of the natural teeth supporting 
the prosthesis; the other two maintained, by means of pivots, two inserted 
human teeth; one of these is lost; the other is still in its place, solidly 
fixed by its pivot. These inserted human teeth, by the religious laws we 

Etruscan applia 

re supporting < 
r disappeared. 


toorh (upper middle incisor on the righr) which 
1 of the Conte Bruschi at Cometo.) 

have before mentioned, could not have been taken from corpses; probably 
they belonged to the person himself, and having fallen out through 
alveolitis, had been reapplied in the manner described above. 

Two Etruscan dental appliances are to be found in the Museum of 
the Conte Bruschi at Corneto: one is similar to those already described, 
and the other, instead, is of a special kind. The first (Fig. 19) is formed 


by a series ot tour rings, embracing the upper canine on the right and the 
three neighboring incisors. It was destined to support a single Inserted 
tooth, the middle incisor on the right; this has disappeared, while the 
pivot bv which it was fixed to the ring is still there, as well as the three 
natural teeth that afforded support to the appliance. 

scan appli 

ided to avoid the bad ctfVct 
artificial substitute. (Mu 

of convergence, or, perhaps, to support 
k-um of Conte Bruschi ai Cometo,) 

The other appliance (Fig. 20) is formed bv two rings; the one surrounds 
the left upper canine, the other the left middle incisor. Between these 
two rings there is not the usual ring crossed by a pivot, but simply a 
small horizontal bar of gold soldered to the two rings. I suppose that 
the person not liking to wear false teeth (one meets with this repugnance 

also at the present day), the dentist has limited himself to putting st 
horizontal bar of gold between the iwo teeth on either side of the missing 
one, in order to maintain them in their normal position and so avoid the 
bad effects of convergence. 

Another ancient dental appliance discovered In ,in Etruscan necropolis 
near Orvieto is now in the possession of the Ghent University, to which 


it was sold.' It still adheres to a piece of upper jaw (Fig. 21), in which 
there are four teeth on each side, that is, on the right, the canine, the two 
bicuspids, and the first molar; on the left, the canine, the second bicuspid, 
and the two first molars. The alveoli of the four incisors are of normal 
width and depth, this signifying that these teeth remained in their places 
until the end of life. The dental appliance, still supported by this fragment 
of a jaw, is made of the purest gold. It is composed of a small band 
curved back upon itself, the ends being soldered together, and, by the 
aid of two partitions, also of pure gold, it forms three compartments, 
two small lateral ones, and one centre one of double the size. The lateral 
compartment on the right contains the canine of the same side; that on 

Fig. 11 

piece as in the preceding figure, seen from (he palatal side. 

the left must have contained the left central incisor, that has now dis- 
appeared, while the large central compartment must evidently have con- 
tained the two incisors on the right side. As there is no pivot in the 
whole appliance, and as the alveoli are not obliterated, there can be no 
doubt that the appliance was simply destined to prevent the loss of the 
two right incisors by keeping them steady. 

It is to be noted, with regard to the Etruscan dental appliances above 
described, that the gold bands of which they were constructed covered a 
considerable part of the dental crown, so that these prosthetic appliances 
certainly could not have had the pretension of escaping the notice of 

' Deneffe, op. cit., p. 63. 


others, they being, on the contrary, most visible. It is in consequence 
to be surmised that in those times the wearing of false teeth and other 
kinds of dental appliance was not a thing to be ashamed of; indeed, 
that it rather constituted a luxury, a sort of refinement only accessible to 
persons of means. Besides this, as the gold in which these works were 
carried out was of the purest quality and in consequence very soft, the 
appliances would not have possessed sufficient solidity if the softness of 
the pure gold had not been counteracted by the width and thickness 
of the bands or strips. 

Fig, 13 

purely ornament a 

ippliance (found in 1SJ65 in a (omb by Cervetn), destined perhaps to support i 
iticiat substitute. (Belonging to Casiellani's collection, Rome.) 

1 Fig. 13. 

A reprod union of the gold piece forming the appliance 

In those of the Etruscan appliances destined for the application of 
inserted teeth, the gum was not made to support the prosthesis, and did 
not, therefore, suffer any compression from the extraneous body, this 
resting entirely, like a bridge, upon the neighboring teeth. From which 
it may be seen that twenty-five centuries and more before our time 
the Etruscans dentists already practised a system of bridge work, and, 
relatively to the age, carried it out with sufficient ability. 


For many centuries the Romans, according to the saying of Pliny, 
Hved entirely "without doctors, although not without medicine;"^ that 
is, there existed without doubt a popular medicine and also a sacerdotal 
medicine, but still there were no persons whose exclusive occupation it 
was to cure disease. 

The medical art, properly so called, was introduced into Rome by the 
Greeks. The first Greek doctor who went to Rome was Archagathus 
(in the year 535 after the foundation of the city, that is, 218 years before 
Christ). His arrival was at first welcomed, so much so that he was 
made a Roman citizen and a shop bought for him in the Acilian square, 
at the expense of the State. However, his popularity was of brief dura- 
tion. Being an intrepid operator, the use and abuse he made of steel 
and fire gained for him the not very honorable qualification of the butcher, 
and he soon became the horror of all the population. 

But it appears that dentistry had begun to be practised in Rome prior 
to the coming of Archagathus, that is, long before the medical profession 
existed. We have the clear proof of this in the Law of the Twelve Tables, 
wherein we find mention made of teeth bound with gold. The Law of 
the Twelve Tables was written in Rome 450 years before Christ, by a 
body of ten magistrates {decemviri) expressly named for that purpose, 
as up to that time no written law had existed. 

As gold was at that time somewhat scarce, and fears were entertained 
that it would become still scarcer (to the great damage of the State) 
by reason of the custom that prevailed among the wealthy of burning 
or burying gold articles with the corpses to honor the memory of the 
deceased, or, rather, to satisfy the pride of the survivors, it was thought 
necessary to prohibit this abuse by a special disposition of the law referring 
to funeral pomps. This disposition was thus formulated: **Neve 
aurum aJJitOy asi quoi auro denies iuncti e scant (sunt) im cum illo sepelirei 
vrive sine fraude esto^"^ that is, "Neither shall gold be added thereto 

' Plinius, lib. xxix, cap. v. 

* This article forms part of the tenth table. The Law of the Twelve Tables was lost, 
but citations and passages are to be found in Cicero and in the works of other Roman juris- 
consults, and by the aid of these it has been possible to reconstruct, at least in part, this 
very ancient code of laws. See Dionysii Gothofredi, Corpus juris civilis. Amstelodami, 
1663; and also Thesaurus juris romani cum prefat. Ottonis, Tome iii, Trajecti ad Rhenum, 



(to the corpse); but it shall not be unlawful to bury or to burn it with the 
gold with which the teeth may perchance be bound together." 

From this it results that at the time when the Law of the Twelve 
Tables was written, that is, four centuries and a half before the Christian 
era, there were already individuals in Rome who practised dental opera- 
tions. And these individuals cannot have been medical men, as at that 
epoch (corresponding pretty nearly with the date of Hippocrates' birth) 
Rome had as yet no doctors. 

The inquiry naturally suggests itself whether the gold mentioned in 
the legal dispositions above cited was used for fixing artificial teeth or 
simply for strengthening unsteady natural teeth. Some authors, Serre 
among them,* have pronounced in favor of the first hypothesis, others, 
as, for example, Geist-Jacobi,^ are rather disposed to accept the second. 
In truth, however, we do not possess sufficient historical data to defi- 
nitely resolve this problem. I myself am rather of opinion that artificial 
teeth were already in use in Rome, as they were, even before this time, 
among the Etruscans. Indeed, if we take into consideration the priority 
of the Etruscan civilization to the Roman and the relations of vicinity 
existing between Etruria and the Roman State, of which it afterward 
became a part, it is even possible that dental prosthesis was first practised 
in Rome by Etruscans. 

In a Greek-Roman necropolis nearTeano (Province of Caserta, Italy) 
there was found in February, 1907, a prosthetic piece of a very peculiar 
construction, and which may be considered as quite unique in its kind. 
It is an appliance destined to support three inserted human teeth (the 
two lower central incisors and the lateral incisor on the right). These 
teeth — lost perhaps by the patient himself, in consequence of alveolar 
pyorrhea — were fixed by means of a system of rings, made of laminated 
gold wire, turned around the teeth and then soldered. 

By the examination of the piece it is easy to argue that the author of 
this prosthesis made at first three separate rings by tightly turning the 
laminated gold wire around each of the three teeth to be applied, and by 
soldering together the ends of the wire forming each ring, after having 
taken away the tooth, in order not to spoil it in making the soldering. 
Then, with another laminated gold wire of sufficient length, he soldered 
the three rings together in due position, put the appliance in the mouth 
and turned the two ends of the wire around the sound teeth, serving 
as a support for the lateral incisor on the left and the two canines. 
After this, he took the apparatus delicately out of the mouth, made the 
soldering necessary for finishing the skeleton of the apparatus, forcibly 

* Josef Serre, Zahnarznei kunst, Berlin, 1804, p. 6. 
^ Geist-Jacobi, Geschichte der 2^hnheilkunde, p. 26. 



put the three teeth in their respective rings again, and applied the pros- 

This ingenious appliance was found still adherent to the mandible of 
a skeleton, in a tomb which, according to the eminent archaeologist 
Dalli Osso, belongs to a period comprised between the third and the 
fourth century before Christ. 

From the nature of the objects found in the tomb near the skeleton (a 
necklace, perfume vessels, etc.) it was quite evident that the skeleton 
bearing the above-described prosthesis was that of a woman. 

As the said appliance was found in South Italy (the ancient " Magna 
Graecia") it is quite probable that it was made by some dentist of the 
Greek colonies. 

The above apparatus belongs to the archeological collection of Signor 
Luigi Nobile, in Teano, in whose possession it was found. 

Fig. 25 

Fig. 26 

Seen from behind. 

Seen from above. 

A prosthetic piece of very peculiar construction (see description), found in 1907 

near Teano, Italy. 

The Romans, as well as the Hebrews, and other peoples of antiquity, 
attributed great importance to the integrity of the dental system. This 
may be deduced with certainty from another article in the Law of the 
Twelve Tables (Table VII, at the rubric De Jelictis), which says: ''Qui 
dentem ex gingiva excusserit libera hominiy trecentis assibus multoiory 
qui servo C L^ (Whoever shall cause the tooth of a free man to fall 
shall pay a fine of three hundred as^ and for that of a slave one hundred 
and fifty.) The as was worth about ten cents American money, so that 
the first fine amounted to about thirty dollars and the second to about 
fifteen dollars. These sums, because of the difference in the monetary 
value in those times, were considered heavy fines. 

After the Romans had conquered Greece (146 B.C.) a very great number 
of Greek doctors went to Rome. The wealth, luxury, and ever-increasing 
corruption of the metropolis caused the practice of the medical art (which 
was almost entirely in the hands of the Greeks) to become a great source 
of lucre. But an art practised with the sole purpose of making money 
soon degenerates to the level of a trade; it is, therefore, hardly to be 


wondered at if ven* few doctors of that epoch have merited being recorded 
in histor}'. 

Among these few, the name Asclepiades (born at Prusa, in Asia Minor; 
died in Rome ninety-six years B.C.) shines with particular lustre. He 
was the founder of the "methodic school," whose curative precepts, 
largely based upon hygiene, come nearer to those of modern scientific 
medicine. Unfortunately, all the writings of this great physician, whose 
name is almost as glorious as that of Hippocrates, have been lost; we 
do not know, therefore, whether and in how far he contributed to the 
development of our specialty. 

But one of the first places in the history of dental art is due without 
doubt to Cornelius Celsus, of whom we will now speak. 

Cornelius Celsus. The historical researches in regard to the life 
of this celebrated author have given but meagre results. It is uncertain 
whether his birthplace was Rome or Verona. The precise dates of his 
birth and death are also unknown; but it is very probable that he was 
born about thirty years before Christ, and that he died during the fifth 
decade of the first century. 

Aulus Cornelius Celsus belonged to the illustrious patrician family 
of the Cornelii. He was a man of great erudition, and wrote on the 
most varied subjects, and among others, on agriculture, on rhetoric, 
on the art of warfare, on medicine, etc. AH these writings, however, are 
lost to us excepting his excellent treatise on medicine. 

Some historians consider that Celsus was a true doctor by profession; 
others, instead, hold that he never undertook the cure of the sick. Neither 
the one nor the other of these opinions is quite acceptable; and it is much 
more likely, as Daremberg observes in his valuable Histoire des Sciences 
Medicalesy that Celsus was one of those philiatri mentioned by Galen, 
who had studied medicine rather from books than at the bedside of the 
sick, but who, although not doctors by profession, in case of necessity, 
put their knowledge and skill into practice on behalf of their relations 
and friends.* 

The work of Celsus, gathered in great part from Greek authors, has 
an especial value, because it sums up, in an admirable manner, the whole 
of the medical and surgical science of the ancients, from the earliest 
times up to the days of Augustus. 

The first book of the work De MeJicitw^ does not contain anything 
of great importance in regard to dentistry. The following hygienic pre- 
cept is, however, worthy of note: "After rising, if it be not winter, the 
mouth should be rinsed with a quantity of fresh water." In regard to 

* See note, p. 15, Hist. Relations of Medicine and Surger>% Allbutt. (C M.) 
=» A. Corn. Celsi de Medicina libri octo, Patavii, MDCCXXII. 


the hygiene of the mouth, nothing more is found in the work of Celsus; 
and it is also necessary to note that the aforesaid precept forms part of a 
chapter, in which he speaks of the rules of life, which must be observed 
by weak people, to which class — the author remarks — belong a greater 
part of the inhabitants of cities and almost all literary men. According 
to Celsus, therefore, perfectly healthy and strong people would not even 
need to wash their mouths with fresh water, and perhaps the keen-witted 
Roman doctor was not wrong; for it is very probable that the saliva 
and mucous secretion of the mouth, in perfectly healthy individuals with 
normal constitutions, have the power of combating the pathogenic germs 
that produce caries and other diseases of the teeth and mouth. In this 
way the fact can be explained of many peasants and the greater part of 
the individuals of the negro race having such good teeth, without possess- 
ing even the remotest idea of what hygiene of the mouth may be. And 
here I venture to refer to a passage in which Celsus alludes to the relation 
between diseases and civilization with its vices: "It is probable that 
in ancient times, although there was but little knowledge of medicine, 
health was for the most part well preserved; this being due to good 
habits, not yet spoiled by intemperance and idleness. These two vices, 
first in Greece and then among us, have brought upon us a very host of 
evils; whence it is that in our days, in spite of the intricate art of medicine 
— once not necessary to us, as it is not necessary to other peoples — few 
among us attain the beginning of old age."* 

In the second book, speaking of the various kinds of disease to which 
the different periods of life are subject, he writes: "Children are espe- 
cially subject to serpiginous ulcers of the mouth, called by the Greeks 
aphthae. . There are also infirmities due to dentition, such as 

ulceration of the gums, convulsions, fever, looseness of the bowels; and 
it is especially the eruption of the canine teeth which produces these 
disturbances. To these, however, very fat children are more particularly 
liable, and those, also, who have costive bowels." 

In Chapter XXV of the fifth book we find the receipt for a narcotic 
drug, recommended by the author for producing sleep in persons tor- 
mented with odontalgic and other pains. This receipt is very compli- 
cated, being composed of ten ingredients, among which are acorns, 
castoreum, cinnamon, poppy, mandrake, and pepper. 

Most important for our subject is Chapter IX,of thesixth book, where the 
author treats of odontalgia. " In toothache, which may be numbered among 
the worst of tortures, the patient," says Celsus, "must abstain entirely 
from wine, and at first, even from food; afterward, he may partake of 
soft food, but very sparingly, so as not to irritate the teeth by mastica- 

' Celsus, lib. i, Preface. 


tion. Meanwhile by means of a sponge he must let the steam of hot water 
reach the affected part, and apply externally, on the side corresponding 
with the pain, a cerate of cypress or of iris, upon which he must then 
place some wool and keep the head well covered up. But when the pain 
is violent, the use of purgatives is very beneficial, the application of 
hot cataplasms on the cheek, and the keeping in the mouth of some hot 
liquid, prepared with fitting medicine, changing this liquid, however, 
very frequently. For this purpose the root of cinquefoil may be boiled 
in wine, or that of hyoscyamus (henbane), or a poppy-head, seedless 
and not too dry, or the root of the mandrake. But in regard to the last 
three remedies, one must be careful not to swallow the decoction whilst 
it is kept in the mouth. For the same purpose one may boil the bark 
of the root of the white poplar in wine, or the scrapings off a stag's horn 
in vinegar or figs in mulse* or in vinegar and honey. It is useful also to 
pass repeatedly around the tooth the end of a probe which has first 
been wrapped around with wool and then dipped in hot oil. It is custom- 
ary also to apply around the tooth certain remedies, after the manner of 
plasters. For this purpose the inside of the peel of dried, bitter pome- 
granates may be pounded with equal quantities of gall-nut and pine bark; 
to these must be added a little minium^ and the whole mixed together 
with the addition of rain water to form a paste; or else a similar paste 
may be formed with equal parts of panax,' poppy, peucedanum,* and 
taminia grape* without stones; or with three parts of galbanum to one of 
poppy. On the cheek, however, must be applied at the same time the 
cerate spoken of above, covered over with wool." 

Celsus then speaks of a revulsive adopted, in his times, against odon- 
talgia. It was composed of myrrh and cardamom, ana one part; saffron, 
pyrethrum, figs, pepper, ana four parts; mustard seed, eight parts. The 
plaster, spread on linen, was to be applied on the shoulder corresponding 
to the side of the pain, and, according as this was situated in a tooth of 
the upper or lower jaw, the revulsive was applied on the back of the 
shoulder, or in front. 

When a tooth is decayed, Celsus advises that there should be no haste 
in drawing it; but that the pain be combated, if the above medicines are 
not sufficient, with others more energetic. A mixture may, for example 

* Wine with honey. 

^ [A/iniwm is an ancient name for red oxide of lead; it was also applied to mercuric 
sulphide or vermilion, and the term vermilion was also used as a designation for granum 
tinctorum or kermeSy the coccus ilicis^ a variety of cochineal extolled by Galen for its 
medicinal properties. The exact nature of the meaning of minium in this connection is 
not altogether clear. — E. C. K.] 

' A species of herb (all-heal). * Peucedanum officinale, hog*s fennel. 

* A species of wild grape thus called because it is red like minium (vermilion). 


be applied to the tooth, composed of one part of poppy, two of pepper, 
and ten of sory,^ pounded and mixed to a paste with galbanum; or else, 
especially in the case of a molar tpoth, the remedy of Menemacus, result- 
ing from saffron, one part; cardamom, soot from incense, figs, pepper, 
pyrethrum, ana four parts; mustard seed, eight parts; or even a more 
complicated remedy made with pyrethrum, pepper, and elaterium,' 
ana one part; scissile alum,^ poppy, taminia grape, crude sulphur, bitu- 
men, laurel berries, mustard seed, ana two parts. 

** If, says Celsus, the pain renders necessary the removal of the tooth, 
this may be made to fall to pieces, by introducing into the cavity a pepper 
berry without its skin, or a berry of ivy, pared in the same way. The 
same result may be obtained in the following manner: The sharp bone 
(aculeus) of that flat fish called by the Greeks trygon and by us pastinaca, 
must first be roasted and then reduced to powder and mixed with resin, 
so as to form a paste; which applied around the tooth will make it fall 
out. Likewise, scissile alum induces the fall of the tooth, when intro- 
duced into its hollow. This substance, however, is best introduced 
into the small cavity, after being wrapped around with a tuft of wool, 
for thus the pain is soothed and the tooth preserved.'' 

Somewhat curious is the following passage, in which Celsus speaks 
of the superiority of a method of cure used by peasants, compared to the 
remedies advised by the doctors. From his words we clearly see that 
he, as we have already remarked, did not belong to the class of doctors 
properly so called. 

** These are the remedies accepted and held in account among the 
doctors. But it is known through the experience of peasants, that when 
a tooth aches one must pluck up wild mint by the roots, put it into a 
large vessel, pour water on it, and make the patient sit near it, covered all 
around with a blanket; and red hot stones should then be thrown into the 
water, so that they be entirely immersed; and then the patient, wrapped 
all around, as we have said before, and keeping his mouth open, receives 
into it the steam evaporated from the water. Thus profuse perspiration 
is induced, and a great quantity of pituita flows from the mouth, and with 
this a cure is obtained for a very long period, often for more than a year." 

In the six following chapters of the sixth book, Celsus treats of the 
diseases which aflfect the soft parts of the mouth. Against tonsillitis, 
he recommends, among other things, the application of a remedy prin- 
cipally made of the juice of the sweet pomegranate, cooked, by a slow fire, 

* Species of mineral. [An impure copper sulphide. — E. C, K.] 

^ Condensed juice of the seeds of the momordica elaterium, a bitter, irritating, and 
drastic substance. 

' According to De Giorgi (Sinonimia chimico-farmacotecnica, Milan, 1889), scissile 
alum is one of the many names for blue vitriol or sulphate of copper. 


to the consistency of honey. The same remedy is also of great value, 
according to the author, for the cure of ulcers of the mouth, when they 
are accompanied by inflammation, and are somewhat foul and of a 
reddish color. But under such circumstances it will also be necessary to 
keep frequently in the mouth an astringent decoction, to which a little 
honey has been added. The exercise of walking is also profitable, as 
well as the taking of food that is not acid. When, however, the ulcers 
begin to be clean, the mouth should be frequently filled with a softening 
liquid or even with simple pure water. It is also helpful to drink genuine 
wine and to eat rather freely, avoiding, however, acid food. The ulcers 
must be sprinkled with a powder composed of two parts of scissile alum 
to three of unripe gall-nuts. If, however, the ulcers are already covered 
with a scab similar to those produced on burns, some of those composi- 
tions should be used which are called by the Greeks antherce; for example, 
a remedy may be formed of equal parts of cyperus,^ myrrh, sandarac, 
and alum; or another which contains saflfron, myrrh, ana two parts; 
iris, scissile alum, sandarac, ana four parts; cyperus, eight parts. 

"Much more dangerous, says Celsus, are those ulcers of the mouth 
which the Greeks call aphtha; they oftentimes lead to death in children; 
in adult men and women, however, there is not the same danger. These 
ulcers begin in the gums; then they attack the palate and the whole of 
the mouth, and finally extend to the uvula and to the fauces; when these 
parts are attacked, it is not very likely that a child will recover." 

As to the ulcers of the tongue, Celsus says that those which are situated 
at the borders of this organ last a very long time, and he adds: "It 
should be seen whether there may not be some sharp tooth opposite, 
which hinders the ulcer from healing; in case such a tooth exists, it should 
have its edge taken oflf" with a file." 

He then passes on to speak of the diseases of the gums: "Often 
small painful tumors, called by the Greeks parulides^ are produced on 
the gums. It is necessary at the very first to rub them softly with 
powdered salt, or with a mixture of burnt mineral salt, cyperus, and 
catmint, meanwhile keeping the mouth open until there flows from it 
a good quantity of pituita; after which the mouth must be rinsed with a 
decoction of lentils. But if the inflammation is great, the same remedies 
must be used as are adopted for the ulcers in the mouth, and between the 
tooth and the gum must be inserted a small tent of soft lint, on which has 
been smeared some one of those compositions which we have said are called 
anthertp. If this, owing to the hardness of the tumor, is not possible, 
then by means of a spoftge the steam of hot water should be made to act 

^ [The cyperus rotundus^ recommended by Dioscorides in the treatment of ulcers in the 
mouth. Esteemed also by the Arab medical writers Scrapion, Avicenna, and Rhazes. Not 
the cypress, cuprcssus sempervirens, — E. C. K.] 


upon the diseased part, and, besides, an emollient cerate must be applied 
upon it. 

"Should suppuration show itself, it will be necessary to use the above- 
mentioned steam for a longer period; to keep in the mouth hot mulse, 
in which some figs have been cooked, and to lance the tumor before it 
is perfectly ripe, so that the pus may not, by remaining too long in the 
diseased part, injure the bone. But if the tumor be of great size, it will 
be more advisable to remove it entirely, so that the tooth remain free 
on both sides. After the pus has been extracted, if the wound be a small 
one, it is sufficient to keep hot water in the mouth, and to use externally 
fomentations of steam, as mentioned above; if it be large, it will be fitting 
to use the decoction of lentils and the same remedies with which all other 
ulcers of the mouth are cured. 

" It also happens, sometimes, that from an ulcer of the gums — whether 
it follow a parulis or not — one may have for a long period a discharge of 
pus, on account of a broken or rotten tooth, or else on account of a 
disease of the bone; in this case there very often exists a fistula. Then 
the latter must be opened, the tooth extracted, and if any bony fragment 
exist, this should be removed; and if there be anything else diseased, 
this should be scraped away. Afterward, the same remedies which have 
been indicated for the other ulcers of the mouth must be used. 

" If the gums separate from the teeth, it will be useful, in this case also, 
to employ those remedies called anthene. But it is also beneficial to chew 
unripe pears and apples and to keep their juices in the mouth. Equal 
advantage can be derived from keeping vinegar in the mouth, provided 
it be not too strong. 

"Whenever ulcers of the mouth are attacked by gangrene, it is necessary 
first to consider whether the whole body be unhealthy, and in that case, 
to do what is necessary to strengthen it. When the gangrenous ulcer is 
superficial, the use of antherce is sufficient; when it is somewhat deeper, 
a mixture must be applied on it, of two parts of burnt paper* to one of 
orpiment;^ when it is very deep, three parts of burnt paper to a fourth 
part of orpiment must be used; or else, equal parts of roasted salt and 
roasted iris; or lastly, equal parts of chalcites, lime, and orpiment. It 
is, however, necessary to dip a small pledget of lint in oil of roses, and put 
it on the caustic medicinals, so that these may not injure the neighboring 
healthy parts. If the disease is in the gums, and some of the teeth are 
loose, it is necessary to pull them out, for they greatly hinder the cure. 
When this latter, however, cannot be obtained by drugs, the ulcer must 
be cauterized with a red-hot iron." 

* Here is meant the paper made of papyrus and called in Latin charta 
' Trisulphide of arsenic. 


Chapter XII of the seventh book is, of all the work of Celsus, the one 
which presents to us the greatest interest, since there the author treats of 
the surgical operations required by the diseases of the dental apparatus. 

He first speaks of the looseness of the teeth, caused by the weakness of 
their roots, or by the flaccidity of the gums, and says that in these cases 
it is necessary to touch the gums lightly with a red-hot iron, then to smear 
them with honey and wash them with mulse, and later on to strengthen 
ihem by means of astringent substances. 

"When a tooth aches, and it is thought well to extract it, because 
medicaments are of no use, the gum must be detached all around, and 
then the tooth must be shaken until it is well loosened, it being very danger- 
ous to draw a firm tooth, as this may sometimes give rise to a dislocation 
of the lower jaw. And greater still is the danger in regard to the upper 

FiC, 21 


Denial and surgical instritmvnts represented it 
Lateran Museum, Ron 

ral marble of the 

teeth, as this might cause a shock to the temples and eyes. After having 
well loosened the tooth, it must be pulled out by the fingers, if this is 
possible; or if not, with the forceps." 

It is clear that this method of tooth drawing — so excessively cautious 
and timid — must have been very torturing to the poor patients. A 
thousand years and more after Celsus, Abulcasis still counsels the same 
exaggerated precautions, and says that the extraction of a tooth must 
not be performed in a rapid and violent way after the manner of the 
barbers. From this one may see that the operation spoken of was then 
very often performed by certain unprofessional persons, who, being very 
familiar with it, carried it out with great indifference and rapidity, thus 
sparing the patients the long-protracted martyrdom which the erudite 
doctors, followers of Celsus, thought necessary to make them endure. 
Very probably the same happened in the days of the wise Roman doctor. 


When there is a large carious hollow in the tooth to be extracted, 
Celsus recommends that it should first be filled up either with lint or 
with lead, in order to prevent the tooth from breaking under the pressure 
of the instrument. "The latter," he continues, "must be made to act in 
a straight direction, in order to avoid fracture of the bone. The danger 
of fracture is still greater in the case of short teeth ; often the forceps, 
not being able to grasp the tooth well, takes hold of the bone with it and 
fractures the latter. When after the extraction of a tooth much blood 
flows from the wound, this indicates that some part of the bone has been 
broken. It is necessary then to search for the detached piece of bone 
with the probe and to extract it with the forceps. If this be not success- 
ful, an incision must be made in the gums just as large as is necessary 
for the extraction of the fragment. When this is not taken out, it often 
happens that the jaw swells in such a manner as to prevent the patient 
from opening his mouth. In such a case it is necessary to apply to the 
cheek a hot cataplasm of flour and figs, so as to induce suppuration, after 
which the gums must be lanced and the splinter of bone extracted." 

When the teeth show blackish stains, Celsus advises such stains to be 
scraped away, and the teeth afterward to be rubbed with a mixture of 
pounded rose leaves, gall-nuts, and myrrh, and the mouth to be frequently 
washed with pure wine. It is necessary besides, says the author, to keep 
the head well covered, to walk a great deal, and to partake of no acid food. 

" If by eflfect of a blow or other accident some of the teeth become 
loose, it is necessary to bind them with gold wire to the neighboring 
firm teeth, and besides to keep in the mouth astringent substances, for 
example, wine in which the rind of pomegranates has been boiled, or 
into which some burning hot gall-nuts have been thrown." 

"When in a child a permanent tooth appears before the fall of the milk 
tooth, it is necessary to dissect the gum all around the latter and extract 
it; the other tooth must then be pushed with the finger, day by day, 
toward the place that was occupied by the one extracted; and this is to 
be done until it has firmly reached its right position." 

"Now and again it happens that when a tooth is pulled out its root 
remains in the socket; it is then necessary to extract it at once, with the 
forceps adapted for the purpose, called by the Greeks rizagra'^ 

The last book of the work of Celsus treats chiefly of fractures and 
dislocations. In the first chapter the position and form of the bones of 
the whole human body are described, although not very exactly. Speak- 
ing of the teeth, the author says: "The teeth are harder than the bones, 
and are fixed, some on the maxilla (lower jaw) and some on the over- 
hanging bone of the cheeks."^ 

* Celsus did not know of the upper maxillary bones as distinct bones. The same may be 
said of the other bones of the head. Celsus speaks of the osseous sutures and openings, 
but not of the different bones of the skull and face. 


"The first four teeth, being cutting teeth (incisors), are called by the 
Greeks tomici. These are flanked on both sides by one canine. Beyond 
this there ordinarily exist, on both sides, five grinders, except in the case 
of those persons in whom the last molars, which commonly are cut very 
late, have not yet appeared. The incisors and the canines are fixed 
with one single root; but the molars at least with two, some even with 
three or four. In general, the shorter the tooth, so much the longer is 
its root. A straight tooth commonly has a straight root, a curved 
tooth has it generally curved. The root of a temporary tooth produces 
in children a new tooth, which usually pushes out the first; sometimes, 
however, the new tooth appears either above or below it." 

In the seventh chapter Celsus treats of fractures in general, but in 
particular of those of the lower jaw. 

"To reduce a fracture of this bone, it should be pressed in a proper 
manner, from the inside of the mouth and from the outside, with the fore- 
finger and thumb of both hands. Then in the case of a transverse fracture 
(ill which case generally an unevenness in the level of the teeth is pro- 
duced), it is necessary, after having set the fragments in place, to tie 
together the two teeth nearest to the fracture with a silk thread, or else, 
il theMe are loose, the following ones. After this, one should apply 
exteriuilly, on the part corresponding to the lesion, a thick compress, 
dipped in wine and oil and sprinkled with flour and powdered olibanum. 
Thih conipieHN \h to he fixed by a bandage or by a strip of soft leather, 
with M longitudinal Nlit in the middle to embrace the chin, the two ends 
being tied t<igether above the head. The patient must fast the first two 
d#iV'»»J th«*n he in;iv be nourished with liquid food, but in small quantities, 
»iliM»iining, howevet, completely from wine. On the third day it is neces- 
ttMiy IM t^ke oir the apparjitus, and after having fomented the part with 
the tileinn nl hoi waler, to replace it. The same is to be done on the fifth 
diiv, Mhd M» on, until the inflammation has subsided, which generally 
hiippenu Imhii the Nevenih to the ninth day. After the symptoms of in- 
ihiMiinfilinn h»ivr viiniNhed. the patient may take abundant nourishment; 
he niuhi, hnwrvei. ahhiain from chewing until the fracture is completely 
iOMwilidaied; and, thnefore, he will continue to nourish himself with 
boiipb and like Innd. Ilr must also entirely abstain from speaking, 
thprtiallv dining the few days. Fractures of the jaw commonly 
heal frnin the rniiiitHiuh to the twenty-first day. 

**ln liixatinns of the jaw (Chapter XII) the bone is always displaced 
forward; but smnetimes only on one side, and sometimes on both sides. 
When the dislocation is only on one side, the chin and the w^hole jaw 
are found deviated toward the part opposite to the luxation; and the 
similar teeth of the two dental arches do not correspond; but instead 
under the upper incisors will be found the canine tooth of the dislocated 


part. If, however, the luxation is bilateral, the chin inclines and pro- 
jects forward; the lower teeth are farther in front than the upper ones, and 
the muscles of the temples are tightly stretched. The reduction of the 
luxation must be performed as quickly as possible. The patient having 
been made to sit down, an assistant holds the head firmly from behind; or 
else the patient is made to sit with his shoulders against a wall, with a 
hard cushion between this and his head, whilst the assistant holds the 
head against the cushion, and so keeps it steady. Then the operator, 
after wrapping his two thumbs in linen cloth or strips, that they may 
not slip, introduces them into the patient's mouth and, applying the other 
fingers on the outside, firmly grasps the jaw. Then whilst lowering the 
back part of the latter, he shakes the chin and pushes it upward and 
backward, seeking to shut the mouth, and in this way making the jaw 
return to its natural position. 

"The bone having been replaced, if the accident should have given 
rise to pains in the eyes and neck, it will be well to draw blood from the 
arm. After the luxation has been reduced, the patient must be nourished 
for some time on liquid food, and abstain, as much as possible, from 

Caius Plinius Secundus. After Celsus, a very celebrated writer 
on medicine and natural science was Caius Plinius Secundus. He 
was born at Como in the year 23 of the Christian era, and flourished 
from the days of Nero to those of Vespasian. Endowed with a liberal 
education, he gave himself up to public life, filling many important posts, 
among which, that of Governor of Spain under Nero and his successors. 
In the year 79 after Christ, while he was in command of the Roman fleet 
at Misenum, the tremendous eruption of Vesuvius took place, by which 
Pompeii, Herculaneum, and other neighboring cities were destroyed. 
Pliny, driven by the desire to study that marvellous and awful natural 
phenomenon, betook himself to Stabia, but was there suffocated by the 
ashes and smoke erupted by Vesuvius. 

In spite of the many places occupied by him, Pliny found time to write 
many works, and among these the thirty-seven books on Natural History y 
which have given him eternal fame. 

It is not at all to be wondered at that this immense work contains 
a great number of fables, superstitions, and errors of every kind. To 
sift the true from the false was not an easy thing, at a time when there 
was almost no idea as to how natural phenomena were produced, and 
when all scientific criticism was impossible, for the very simple reason 
that true science did not exist. 

To give an idea of the great absurdities which were believed in at that 
epoch, and which were considered possible even by higher intellects such 
as Pliny's, the following passages will suflice: "In many mountains of 


India, according to what Ctesia writes, there are men with dogs' heads, 
who clothe themselves with the skins of wild beasts and bark instead of 
speaking. There are also a kind of men having only one leg, and who 
have great speed in leaping. Others are without any neck and have 
their eyes between their shoulders. Megasthenes writes that among the 
nomad Indians are men who instead of a nose have only holes, and have 
their legs bent like serpents. At the extreme confines of India, toward 
the East, are men without any mouth and with their bodies entirely 
covered with hair, who live on nothing but air and odors, which they 
inhale. through the nose."^ 

In Pliny's day the most prodigious virtues were attributed to herbs; 
in regard to this the following example is sufficient: 

**The herb near which dogs may have made water, when gathered, 
but without being touched by iron, cures luxations very promptly."^ 

It must not be thought that Pliny accepted such beliefs without reserve. 
He notes them, because preceding authors had accepted them, and 
because if certain things appear to us evidently absurd, their absurdity 
could not be equally evident at a period when little more than nothing 
was known in regard to physical and physiological laws, and when the 
impossibility of rationally explaining natural effects led men to admit 
the existence of marvellous virtues and influences in every being and in 
all bodies. On the other hand, Pliny expressly says, for his own justi- 
fication, in Chapter I of Book VII: "I do not want to bind my faith in 
many things which I am about to say; but rather refer the readers to the 
authors from whom I have taken them." 

As is to be expected, we find in Pliny's works, in regard to teeth, a 
strange mixture of truth and errors. 

In Chapter XV of Book VII, after having said that some children 
are born with teeth, and after having cited, as examples, Manius Curius, 
who was therefore called Dentatus, and Gnaeus Papirius Carbo, both 
illustrious men, he adds: 

"In women such a thing was considered a bad augury in the days 
of the kings. In fact, Valeria having been born with teeth, the seers 
said that she would be the ruin of the city to which she would be taken; 
she was sent to Suessa Pometia, which in those days was a very flourish- 
ing city; and, in fact, the prediction was verified. Some, instead of teeth, 
have an entire bone; of this there was an example in the son of Prusias, 
King of Bithynia, who instead of upper teeth had one single bone." 

"The teeth alone are not consumed by fire, and do not burn with 
the rest of the body. And yet these teeth, which withstand the flames, 
are worn away and hollowed out by pituita. They wear out by being 

* C. Plinii Secundi, Historic Mundi, lib. vii, cap. ii. ^ Lib. xxiv, cap. cxi. 


used. Nor are they necessary for mastication alone, for the foremost 
ones regulate the voice and words, producing by the beat of the tongue 
special sounds." 

" Men have thirty-two teeth, women a lesser number. It is, however, 
believed that augury may be taken from the teeth; and to have a greater 
number than usual is considered an indication of long life. The presence 
of two eye teeth at the right side of the upper jaw presages favorable 
fortune, as was verified in Agrippina, the mother of Domitius Nero; 
on the left side, however, they are of sad foreboding." 

"The last teeth, which are called the genuine teeth, appear toward the 
twentieth year of age; many persons, however, do not have them until their 
eightieth year. Teeth fall out in old age and then spring up again; of 
this there can be no doubt. Mutianus writes of having known a certain 
Zancle of Samothracia, in whom teeth reappeared after he had completed 
his one hundred and fourth year. Timarcus, son of Nicocles of Paphus, 
had two rows of molar teeth, whilst a brother of his did not change his 
incisor teeth at all, which, therefore, wore down little by little. There 
once lived a man who had a tooth in his palate. The canine teeth, when 
by any chance they fall out, do not reappear any more."^ 

" In the teeth of man there exists a poisonous substance which has the 
effect of dimming the brightness of a looking-glass when they are pre- 
sented uncovered before it; and if they are uncovered in front of young 
unfledged pigeons, these take ill and die."^ 

The second of these two statements is but a prejudice, like many others; 
but we find the first very strange indeed, it being a surprising thing that 
a man like Pliny should have attributed to an imaginary poison of the 
teeth what is the simple effect of the moistures of the breath. 

In Chapters CXV and CXVII of Book XI are found some observa- 
tions which are somewhat interesting to us: 

"A man's breath becomes infected by the bad quality of food, by the 
bad state of the teeth, and still more by old age." 

"Simple food is very beneficial to man; the variety of flavors instead 
is very harmful. Sour or too abundant foods are digested with difficulty, 
and also those which are ravenously swallowed. As a remedy, vomiting 
has come into use; but it makes the body cold and is most pernicious to 
the eyes and to the teeth." 

There is no doubt that the habit of often provoking vomitus — which, 
in those times of excessive corruption and intemperance, had come into 
general use — must have resulted in enormous harm to the teeth, especially 
by the action exercised upon them by the hydrochloric acid contained in 
the gastric juice, and by the organic acids of fermentation. 

' Lib. xi, cap. Ixiii. ^ Lib. xi, cap. Ixiv 


Among the vegetable remedies in those times considered of use 
against odontalgia, the principal ones are mentioned in Chapter CV of 

''It is beneficial against toothache to chew the root of panax, and 
likewise to wash the teeth with its juice. It is also useful to chew the 
root of hyoscyamus soaked in vinegar, or else that of the polemonium. 
It is also beneficial to chew the roots of the plantain, or to wash the teeth 
in a decoction of plantain in vinegar. A decoction of the leaves is also 
useful, not only in the case of simple toothache, but also when the gums 
are tender and easily bleed. The seed of the same plant cures inflamma- 
tions and abscesses of the gums. The aristolochia strengthens the gums 
and the teeth. The same eflPect may be produced bv masticating the 
verbena with its root, or by washing the mouth with a decoction of it 
in wine or Wnegar. Similarly the roots of the cinquefoil are helpful when 
boiled down to a third, in wine or vinegar; however, they must first be 
washed in salt water or brine. The decoction must be kept for a long 
time in the mouth. 

'' Instead of using the decoction of cinquefoil, some prefer to rub the 
loose teeth with the ashes of this plant. Besides the above-mentioned 
remedies, the root of the verbascum boiled in nHne, hyssop, and the 
juice of the peucedanum with opium are also employed; and it is also 
beneficial to pour into the nostrils, on the side opposite to that of the sick 
tooth, some drops of the juice of anagallis. 

'' It is said that if senecio be taken from the eanh, and the aching 
tooth be touched three times with it, spitting alternatively three times, 
and then the herb be replanted in the same spot, so that it may continue 
to live, the tooth will never give pain any more."* 

"In the fuller's thistle,* an herb which grows near rivers, is found a 
small worm, which has the power of curing dental pains, when the said 
worm is killed by rubbing it on the teeth, or when it is closed up with 
wax in the hollow teeth.'*' 

"Apollonius writes that a \ti\ efficacious remedy for pains in the 
gums is to scratch them with the tooth of a man who has suffered a 
violent death.'** 

" It is considered ver\ beneficial for toothache to bite off a piece from 
wood which has been struck bv lightning, and to touch the sick tooth 
with it; but whilst biting off the linle piece of wood, it is necessar\* to keep 
both hands behind the back."^ 

''Experience teaches that against the bad odor of the breath it is 
useful to wash the mouth uith pure wine before sleeping, and that to 

^ Cap. oi. ' Dipsacus fullonum. 

' Cap. o-iii. * Lib. xxviii, cap. it. ^ Lib. xxviii, cap. xi. 


avoid aching of the teeth, it is a good thing to rinse the mouth, in the 
morning, with several mouthfuls of fresh water, but of an odd number."* 

"A remedy for toothache is to touch the diseased teeth with the tooth 
of a hyena,' or to scratch the gums with the tooth of a hippopotamus 
which has been taken from the left side of the jaw."' 

**The ashes of stag's horn, rubbed over loose and aching teeth, makes 
them firm and soothes the pain. Some consider that to produce the 
same effect, of greater virtue is the powder of the horn, unburnt. Both 
the ashes and the powder of stag's horn are employed as a dentifrice. 
The ashes of the head of a wolf are a great remedy for toothache. Such 
pains are also made to cease by wearing certain bones that are often- 
times found in the dung of this animal. The ashes of the head of a hare 
is a useful dentifrice; and if spikenard be added, it will lessen the bad 
smell of the mouth. Some mix with it the ashes of the heads of mice. 
In the side of the hare is a bone as sharp as a needle; and many advise 
pricking the teeth with this when they ache. The heel of the ox kindled 
and brought close to loose teeth makes them firm. The ashes of this 
bone mingled with myrrh is a good dentifrice. A good dentifrice is 
also made from the ashes of the feet of a goat. To strengthen teeth 
loosened by a blow, asses' milk or the ashes of the teeth of this animal 
are very useful. In the heart of the horse there is a bone like an eye- 
tooth; it is said that it is very beneficial to pick with it the teeth that ache. 
The carpenter's glue boiled in water and plastered on to the teeth also 
takes away their pain; but soon after it must be taken away and the 
mouth rinsed with wine in which have been boiled the rinds of sweet 
pomegranates. It is also thought beneficial to wash the teeth with goat's 
milk or with ox-gall."* 

"Butter, either alone or with honey, is very useful for children; and is 
very helpful, especially during dentition, in the diseases of the gums, and 
to cure the ulcers of the mouth. To prevent the disorders that generally 
accompany dentition, it is a useful thing that the child should wear a 
wolf's tooth, or one of the first teeth lost by a horse. The rubbing 
of the gums with goat's milk or with hare's brain renders the cutting of 
teeth much easier."* 

"To sweeten the breath it is very helpful to rub the teeth and the 
gums with wool and honey."* 

"The filth of the tail of sheep rolled up in little balls, and left to dry 
and then reduced to powder and rubbed on the teeth, is marvellously 
useful against the loosening and other diseases of the teeth themselves 
and against the cankerous ulcers of the gums."^ 

* Lib. xxviii, cap. xiv. ^ Ibid., cap. xxvii. ^ Ibid., cap. xxix. 

* Ibid., cap. xlix. • Ibid., cap. Ixxviii. • Lib. xxix, cap. ix. 
^ Lib. xxix, cap. x. 


" Eggshells deprived of their internal membrane and afterward burnt 
afford a good dentifrice."* (Hence we see that the use of carbonate of 
lime as a dentifrice is a very ancient one.) 

" If the head of a dog that has died mad be burnt, the ashes obtained 
may be advantageously used against toothache, mixing it with cyprine 
oil and then dropping the mixture into the ear, on the side of the pain. 
It is beneficial also to pick the sick tooth with the longest tooth, on the 
left side, of a dog; or with the frontal bones of a lizard, taken from the 
head of the animal at full moon, and which have not touched the earth. 
The teeth of a dog, boiled in wine until this is reduced to one-half, thus, 
furnish a mouth wash which can be advantageously used against tooth- 
ache. In the cases of difficult dentition, benefit is derived by rubbing 
the gums with the ashes of the teeth of a dog, mixed with honey. Such 
ashes are also used as a dentifrice. In hollow teeth it is useful to intro- 
duce the ashes of the dung of mice, or of the dried liver of lizards. It is 
the opinion of some, that in order not to be subject to toothache, a mouse 
should be eaten twice a month. If earth-worms be cooked in oil, this 
latter has the virtue of calming toothache when dropped into the ear on 
the side of the pain. The same effect is obtained by rubbing the teeth 
with the ashes of the aforesaid worms, after they have been burnt in a 
terra-cotta vase ; and if such ashes be introduced into the hollow teeth, 
these fall out very easily. A good remedy against toothache is to wash 
the mouth with vinegar of squills in which earth-worms and the root of 
the mulberry have been boiled. The ashes of the shells of snails mixed 
with myrrh, rubbed on the gums, strengthens them. Even the slough 
which the snakes cast off in spring can furnish a remedy against tooth- 
ache. For this purpose it must be boiled in oil, with the addition of 
resin of the larch, and then the oil dropped into the ear. For the same 
purpose, according to some, oil of roses is useful, when a spider, caught 
with the left hand, has been pounded in it. If a sparrow's fledglings 
be burnt with dry vine twigs, the resulting ashes rubbed with vinegar on 
the teeth makes all pain cease in them.^ It is stated by many that to 
improve the odor of the breath, it is well to rub the teeth with ashes of 
mice mixed with honey. Some also mingle with this the root of fennel. 
Picking the teeth with the quill of a vulture renders the breath sour. It 
makes the teeth firm to pick them with a porcupine's quill. A decoction 
of swallows in wine sweetened with honey cures ulcers of the tongue 
and lips. Scaldings in the mouth produced by hot food or drinks are 
readily healed with the milk of a bitch.''' 

That Pliny did not put great faith in many of the things which he 
relates is clearly proved by several passages of his book, and among 
others by the following: 

' Lib. xxix, cap. xi. * Lib. xxx, cap. viii. ' Lib. xxx, cap. ix. 


**One can hardly relate without laughing, some things, which, however, 
I will not omit, because they are found already written. They say that the 
ox has a small stone in the head, which it spits out when it fears death; 
but if its head be suddenly cut off, and the stone extracted, this, worn 
by a child, helps it in wondrous manner to cut its teeth. "^ 

In Book XXXI, Pliny speaks of various waters — mineral, thermal, 
etc. — especially from the medical point of view. It was already known 
in those days that those waters were most active agents. And in this 
respect a fact which the author relates in Chapter VI of Book XXV is 
worth mentioning: 

"When Caesar Germanicus moved his camp beyond the Rhine, there 
was found, in the whole maritime tract of the country, only one spring 
of fresh water, the drinking of which, within two years, produced the 
fall of teeth and a loosening of the knee-joints. The doctors called these 
evils stomacace and scelotyrbe." 

Sea salt and nitre are of use, according to Pliny, against various maladies 
of the teeth and mouth. He counsels the application of salt on lint to 
the ulcers of the oral cavity, and to rub it on the gums when they are 
swollen. To prevent diseases of the teeth, it would be advantageous, 
every morning before breaking one's fast, to keep a little salt under the 
tongue until it is dissolved. Against the pain of the teeth it would be 
beneficial to use common salt dissolved in vinegar, or nitre in wine. 

"The rubbing of the blackened teeth with burnt nitre gives them back 
their natural color."^ 

The prophylactic remedies against odontalgia believed in, at that period, 
were sufficiently numerous, and, among many other such things, Pliny 
informs us that in order not to be subject to toothache, it is sufficient 
to wash the mouth three times a year with the blood of the tortoise.' 
Analogous virtue was also attributed to the brain of the shark, which 
was boiled in oil, and this put by for washing the teeth with once a year. 

Besides the many anti-odontalgic remedies so far related, several others 
are found enumerated in Chapter XXVI of Book XXXII: 

"The pain in the teeth is lessened by picking the gums with the bones 
of the sea dragon. It is also very beneficial to pick the gums with the 
sharp bone of the puffin.* If the same be pounded together with white 
hellebore, and the mixture thus obtained be rubbed on the diseased teeth, 
they may be made to fall out without pain. The ashes, also, of salt 
fish burnt in an earthen vase, with the addition of powdered marble, 
is a remedy against toothache. Frogs are also boiled in a hemina'* of 

' Lib. XXX, cap. xlvii. * Lib. xxxi, cap. xlv, xlvi. ^ Lib. xxxii, cap. xiv. 

* Trygon pastinaca, a large fish whose tail is armed with sharp and strong bones. 
*A measure equal to 0.274 liter. 


vinegar, the decoction being then used to wash the teeth with; but this, 
however, must be kept in the mouth for some length of time. In order 
to render this remedy less nauseous, Sallustius Dionisius used to hang 
several frogs, by their hind feet, over a vase in which he boiled the vinegar, 
so that the juices of the animals might drip into this from their mouths. 
To make loose teeth firm, some advise the soaking of two frogs, after 
having cut off their feet, in a hemina of wine, and the washing of the 
mouth with the latter. Others tie them, whole, on the jaws. Some, to 
strengthen unsteady teeth, rinse them with a decoction made by boiling 
ten frogs in three sextaries* of vinegar, until the liquor is reduced to one- 
third. By others, thirty-six hearts of frogs are well boiled in a sextary 
of old oil, in a copper vessel, and the oil is then used against toothache, 
dropping it into the ear, on the side of the pain. Some, after having 
boiled the liver of a frog, pound it with honey, and smear it on the sore 
teeth. If the teeth are decayed and fetid, many counsel the drying of 
a hundred frogs in an oven, leaving them there for one night, then the 
addition of an equal weight of salt, reducing the whole to powder, and 
rubbing the teeth with it. In such cases the ashes of ccabs are also 
used. That of the murex' is adopted as a simple dentifrice." 

" The cutting of teeth is facilitated by rubbing the gums of the child 
with the ashes of dolphin's teeth mixed with honey, or even simply by 
touching the gums with a tooth of this animal."' 

In Chapter XXXIV of Book XXXVI it is said that the decoction of 
gagates* in wine cures the diseases of the teeth; and in Chapter XLII of 
the same book are praised the dentifrice powders made of pumice stone. 

From the examination of Pliny's work several important facts come 

The diseases of the teeth were, in those days, most common; very often 
we find mention of loose teeth, and the medicines suited to make them 
firm again; from which we may deduce the great frequency of alveolar 
pyorrhea. It is reasonable to think that such a fact was caused prin- 
cipally by the intemperate life of those times, in which the followers of 
Epicurus were extremely numerous and the unbridled desire for pleasure 
reached such a degree that no abhorrence was felt of provoking vomit 
during the course of a long banquet, in order to continue dining merrily. 

Concerning the teeth, their affections, and the means of healing and 
preventing them, the strangest superstitions existed, and this not only 
among the common, but also among educated and learned people. 
The number of remedies reputed useful against diseases of the teeth 

' [The sextarius was accorded different values, thus a sextary of oil was Sxviij, of wine 
5xx, and of honey, Jxvij. — E. C. K.] 
' [Lat., the purple fish, a carnivorous marine mollusk. — E. C. K.] 
' Lib. xxxii, cap. xlviii. * A kind of lignite, now called jet. 


was extraordinarily great; but the modern saying, "therapeutic wealth 
is poverty," could have been applied only too well. 

Of the cleanliness of the teeth, it seems, great care was taken, for denti- 
frices were in great use. These, as we have already seen, were made 
of the most varied substances — stag's horn burnt, ashes obtained by 
burning the head of the mouse, of the hare, of the wolf, etc., eggshells 
burnt and reduced to powder, pumice stone, and so on. For the cleanli- 
ness of the mouth, for strengthening the teeth and gums, mouth washes 
of sundry kinds were likewise adopted, especially formed of decoctions 
of astringent substances in water, wine, and vinegar. 

Not only among the Romans was great care given to the cleanliness and 
beauty of the teeth, but also among many other nations. In this regard 
the following poem of Catullus, in which he lashes the silly vanity of a 
Celtiberian resident in Rome, who made continual show of his white 
teeth, is somewhat interesting: 

"Egnatius, quod candidos habet dentes 
Renidet usquequaque; seu ad rei ventum est 
Subsellium, cum orator excitat fletum, 
Renidet ille: seu pii ad rogum filii 
Lugetur, orba cum flet unicum mater, 
Renidet ille; quidquid est, ubicumque est, 
Quodcumque agit, renidet: hunc habet morbum, 
Neque elegantem, ut arbitror, neque urbanum. 
Quare monendus es mihi, bone Egnati, 
Si Urbanus esses, aut Sabinus, aut Tiburs, 
Aut parcus Umber, aut obesus Hetruscus, 
Aut Lanuvinus ater, atque dentatus, 
Aut Transpadanus, ut meos quoque attingam, 
Aut quilibet, qui puriter lavit dentes: 
Tamen renidere usquequaque te nollem; 
Nam risu inepto res ineptior nulla est. 
Nunc, Celtiber, in celtiberia terra 
Quod quisque minxit, hoc solet sibi mane 
Dentem, atque russam defricare gingivam. 
Ut quo iste vester expolitior dens est, 
Hoc te amplius bibisse praedicet lotii."* 

' Ignatius, because he has white teeth, is always laughing; if he be present at the felon's 
trial, whilst the counsel is moving all to tears, he laughs; he laughs even when everyone is 
mourning at the funeral pyre of a dutiful son, whilst the mother is weeping for her only child. 
He laughs at everything, everywhere, and whatever he be doing; this is his weakness, which 
methinks is neither polite nor elegant. Wherefore, I must tell thee, O good Ignatius, even 
if thou wert a citizen of Rome, or a Sabine, or of Tibur, or one of the thrifty Umbrians, 
or of the fat Etruscans, or wert thou a black and large-toothed Lanuvin, or a Transpadane, 
if I may speak of my own people, or belonging to any people that cleanly wash their teeth; 
even then I would not have thee be always laughing; for nothing is more silly than a silly 
laugh. Now, O Celtiberian, in thy Celtiberian land, each is accustomed, with the water 
he has himself emitted, to rub his teeth and gums. Wherefore the cleaner are thy teeth, 
the more surely stale dost thou accuse thyself of having drunk. 



Strabo. From Strabo we learn that the Cantabri and other peoples 
of Spain used to clean their teeth and sometimes even to wash their 
face not with fresh, but with old urine, which, so it seems, was kept for 
the purpose, in suitable cisterns!* 

In regard to this filthy custom, Joseph Linderer says' that the super- 
stition has reached even to our times, although not widely diffused, that, 
to beautify the face, it is useful to wash it with urine. He relates that 
he knew a girl who, to become beautiful, had recourse to this heroic 
method, but, unfortunately, without at all obtaining the desired end ! 

Martial. In the epigrams of Martial (about 40 to loi a.d.) allusions 
of great value with regard to several points concerning the subject we 
are treating of are found. 

Toothpicks (dentiscalpia) are mentioned by this poet several times; 
from which we may argue that they were in great use. They were 
ordinarily made of lentisk wood (Ptstacia lentiscus), as may be deduced 
from the Epigram LXXIV of Book VI, in which the author ridicules the 
old dandy who, stretched at length on the triclinium, cleans with lentiski 

Fig. 28 

An ancient toothpick and ear-picker of gold, found in Crimea. 

the toothless mouth, to give himself the air of a man not too far stricken 
in years.' Besides, in Book XIV, containing, for the greater part, saws 
and sayings on objects of common use, there is an epigram bearing the 
title of "Dentiscalpium," in which the author says that toothpicks of 
lentisk are to be preferred, but that, in their absence, quill toothpicks 
may be used.* 

From other sources we learn that in those days metal toothpicks 
were also made use of. So in a satire of Petronius, it is said that Trimal- 
chiones made use of a silver toothpick {spina argentea). Objects of this 
kind, both Roman and of other origin, are even now in existence, and 

* Rerum geographicarum libri. ' Lutetix Parisiorum, 1620. Lib. iii, p. 164; quippe 
qui urina in cisternis inveterata laventur, eaque cum ipsi, tum eorum uxores dentes tergant; 
quod Cantabros facere et eorum confines ajunt (Carabelli, Systematisches Handbuch der 
Zahnheilkunde, Wien, 1844, i, 12). 

* Handbuch der Zahnheilkunde, Berlin, 1848, ii, 412. 
' Medio recumbit imus ille qui lecto, 

Calvam trifilem segmentatus unguento, 
Foditque tonsis ora laxa lentiscis; 
Mentitur, Esculane; non habet dentes. 

* Lentiscum melius; sed si tibi frondea cuspis 
Defuerit, dentes penna levare potest. 


may be found in various collections of antiquities. In Crimea a most 
elegant gold object, of Greek make, was found, which is, by its two ends, 
both a toothpick and an ear-picker. It belongs most probably to the 
fourth century before Christ.' 

In an object found in the north of Switzerland, and coming from a 
Roman military colony of the times of the Empire, the toothpick and 
ear-picker are joined at one of their ends, by a pivot, to other toilet 

Fig. 29 

lal looihpicl: and 

ilet articles. An object foa 

Hilary colony. 

An ancient toothpick and ear-picker of bronze, found in the nonh of France, 
at Bavai (the ancient Bagacum). 

Caylus, in his valuable work Recuetl d'anttquites egyptiennes, eirusques, 
grecques, romaines et gaulotses (Paris, 1752 to 1767), gives the picture 
of a toothpick and earpicker of bronze, two inches long, with the middle 
part wrought in spiral form, so as to increase the solidity of the anicle, 
and also to enable the hand to keep it easily firm in all positions. It 
was found in the north of France, at Bavai (the ancient Bagacum), and 
forms part of the collection of M. Mignon of Douai.' 

' Antiq. du Bosphore au Musee de I'Ermitagc, pi. xxx, 8 et 9 (Dictiimnaire des antiquite 
fCtecques et romaines, par Daremberg, Saglio, etc). 

' Mitiheilung. d. antiq. Gesellschaft in Ziirich, xv, pi. xi, 32 (Daremberg and Saglio, ibid.] 
' Caylus, vol. vi, pi. cxxx, 5. 


Martial is one of the first Roman writers who speak clearly of artificial 
teeth. In Epigram LVI of Book XIV, the poet, by a bold personification, 
makes the dentifrice powder say to a toothless old woman, furnished 
with false teeth: "What have you got to do with me? Let a girl use 
me. I am not accustomed to clean bought teeth. "^ 

Elsewhere' Martial atrociously derides a courtesan, who, among her 
other physical defects, was also without an eye: "Without any shame 
thou usest purchased locks of hair and teeth. Whatever will you do 
for the eye, Laelia.^ These are not to be bought!"' 

This epigram shows that, while dental prosthesis was already in use, 
ocular prosthesis did not as yet exist. 

To a plagiarist, who passed off Martial's poetry as his own, the latter 
says: "With our verses, O Fidentinus, dost thou think thyself and 
desire to be thought a poet. Even so, it seems to ^gle that she has all 
her teeth, because of her false teeth of bone and ivory.'** 

There is, therefore, not the least doubt that in the days of Martial 
artificial teeth were in use; and that these, as may be seen from the 
epigram just now quoted, were made of ivory and bone; we do not know 
whether they were formed also of other substances. The question, how- 
ever, arises: In those times did they manufacture movable artificial 
sets, or was the dental art then limited to fixing the artificial teeth un- 
movably to the neighboring firm teeth, by means of silk threads, gold 
wire, and the like ^ The answer to this question may be found in another 
epigram of Martial,^ where the latter ridicules a wanton old woman, 
telling her, among other things still worse, that she at night lays down 
her teeth just as she does the silken robes.^ 

It is, therefore, beyond all doubt that, at that period, the manner of 
constructing movable artificial sets was known; and most probably not 
only partial pieces were made, but even full sets. In fact, from the verse 
quoted above we have justly the impression that the poet means a whole 
set rather than a few teeth. 

From the words of Martial, it may also be concluded that these dentures 
could be put on and off with the greatest ease; or, as we may say, by a 

^ Dentifricium ad edentulam: 

Quid mecum est tibi ? me puella sumat, 

Emptos non soleo polire dentes. 
^ Lib. xii, epig. xxiii. 
' Dentibus atque comis, nee te pudet, uteris emptis. 

Quid facies oculo, Laelia ? non emitur. 
* Nostris versibus esse te poetam, 

Fidentine, putas, cupisque eredi ? 

Sic dentata sic videtur i^gle, 

Emptis ossibus, indicoque cornu. (Lib. i, epig. Ixxii.) 
' Lib. ix, epig. xxxviii. • Nee dentes aliter quam serica nocte reponas 


maneuver as simple as that of removing any articles of apparel; they must, 
therefore, have been extremely well constructed. 

This alone should be sufficient, even were further proof wanting, to 
give us an idea of the degree of development and of the point of perfection 
reached by dental prosthesis at that time. But besides this, we now 
also possess an ancient Roman piece furnishing a palpable proof of the 
ability and ingenuity of the dentists of that epoch. Some few years since, 
I had occasion, in the pursuit of dental archeological research, to visit the 
Museum of Pope Julius in Rome, where I was shown a prosthetic piece, 
not yet exhibited to the general public, that had been discovered a few 
months previous in excavating at Satricum, near Rome, I was invited 
to give an opinion as to this appliance, and, after having examined it 
accurately, became aware, not without some emotion, I am fain to con- 
fess, that 1 held in my hands a prosthetic piece of exceptional historical 
importance, that is, no less than a specimen of ancient crown work. 

ide or gold. 

Fic. 31 

The appliance found at Satricum (Fig. 31) is made in the following 
manner: Two small plates of gold, stamped out, represent respectively 
the lingual and labial superficies of a middle lower incisor; these two 
pieces soldered together form the crown of the tooth. At its base the 
crown is soldered, back and front, to a narrow strip of gold which folds 
back on itself at each end, so as to tightly encircle the two neighboring 
teeth on the right and on the left, which thus serve as supports to the 

We are now, therefore, able not only to affirm that the Etruscans 
knew how to execute a kind of bridge work, but that later the dentists of 
ancient Rome even carried out crown work. 

This, notwithstanding the examples of dental prosthesis discovered 
up to now in Roman and Etruscan tombs, can in no way be considered 
as representing all the varieties of dental prosthesis of ancient construc- 
tion. It is to be hoped that, in spite of the destructive action of time, 
in continuing the excavations and archeological researches, many other 
specimens of early dental prosthesis will yet come to light. In any case, 


judging by some indications to be found in Latin literature, it must be 
admitted that the Roman dentists of antiquity constructed other kinds 
of prosthesis besides the specimens we possess, and in particular movable 
dentures. We are led to suppose this, not only from the above cited 
epigram of Martial, but also from what we read in one of the satires of 
Horace, who dates contemporarily with Augustus, and therefore anteriorly 
to Martial. Speaking of two old witches who had been put to flight 
by Priapus, Horace writes: "You would have laughed to see those two 
old witches run toward the town, losing in their flight, Canidia, her false 
teeth, Sagania, her false hair."^ 

Now, as Prof. DenefFe very rightly observes, the prosthetic appliances 
of antiquity known to us are so firmly fixed to the natural teeth that no 
race, however unbridled, could ever have made them fall out of the mouth. 
It must, therefore, be admitted, as I have said, that the ancients con- 
structed other kinds of dental appliances, of which no specimens have, 
as yet, been discovered. 

Neither in Celsus nor in Pliny, nor in any other Roman writers on 
medicine, do we find any allusion to the art of dentistry. The doctors 
of those days probably had no idea of the advantages which could be 
derived from dental prosthesis in regard to digestion and consequently 
to the health of the whole body. They therefore must have considered 
artificial teeth as something totally foreign to their art, and intended solely 
to hide a physical defect. It is therefore not at all surprising that they 
have not treated of this subject. 

As the art of setting artificial teeth was exercised by persons not be- 
longing to the medical profession, it is very probable that these persons 
also undertook the extraction of teeth and the cure of dental pains. 
Martial (Book X, Epigram LVI) names a certain Cascellius, who, 
he says, "extracts or cures diseased teeth,"' and this is the first dentist 
whose name has been sent down to us. In spite of this, nothing permits 
us to affirm that there existed at that time a class of real dentists, viz., 
of persons dedicated to the exclusive cure of dental disease. There are 
strong reasons for doubting this, especially when we consider that the 
Latin language has no word corresponding to the word dentist. If 
there had existed a true dental profession, there ought also to have existed 
a name for indicating the individuals who exercised it. Therefore, it 
must be considered highly probable that, although there undoubtedly 
existed individuals who were especially skilled in the cure of the diseases 
of the teeth, such persons did not form a special class; perhaps, among 
those to whom recourse was had for the cure of dental diseases, some were 
doctors, particularly skilled in such diseases, others were perhaps barbers, 

^ Horat. Sat. viii, lib. i. ' Eximit aut reficit dentem Cascellius segrum. 


and so forth. " As to the far-fetched deductions of Geist-Jacobi, according 
to whom the name given to dentists by the Romans must have been 
that of artifex dentium or artifex medicus dentiumy these are founded, 
above all, on imagination. It is extremely improbable that such names 
existed, when one considers that they are not met with, even once, in the 
whole range of Latin literature. 

ScRiBONius Largus. Among the writers on Medicine in the early 
period of the Empire, one of the most eminent was, without any doubt, 
Scribonius Largus, physician to the Emperor Claudius, whom he accom- 
panied to England in the year 43. 

Scribonius Largus, in his book De compositione medicamentorurriy 
pronounces himself energetically against the division of Medicine into 
single special branches. He declaims against the many who attributed to 
themselves the name of doctors, simply because they knew how to cure 
some diseases. According to him, the true doctor must be skilled in 
curing all kinds of affections. This, in truth, was possible in those times, 
but would be almost impossible nowadays, on account of the enormous 
development of the healing art. The ideas, however, expressed by 
Scribonius Largus have a certain historical importance, for they show 
that in his times the medical art had certainly the tendency to split up 
into many special branches, among which there must certainly have been 
dentistry, but that the necessity of such separation was not by any means 
universally recognized; the great doctors of those days undertook the 
cure of the diseases of the teeth, as well as those of any other part of 
the body. 

The tenth chapter of the book of Scribonius Largus treats of the cure 
of odontalgia. The author begins by saying that it is the opinion of many 
that the only true remedy against toothache is the forceps. With all this, 
he adds, there are many medicaments, from which great benefit may be 
derived against these pains, without it always being necessary to have 
recourse to extraction. Even when a tooth is affected with caries, says 
the author, it is not always advisable to extract it; but it is much better, 
in many cases, to cut away the diseased part with a scalpel adapted for 
the. purpose. 

"Violent toothache may be calmed in various ways, viz., with mouth 
washes, masticatories, fumigations, or by the direct application of fitting 
medicaments. It is beneficial to rinse the mouth frequently with a decoc- 
tion of parietaria or of cypress berries, or to apply to the tooth the root or 
the seeds of the hyoscyamus wrapped up in a cloth, and dipped from 
time to time in boiling water, or to chew the portulaca (purslane), or to 
keep for some time its juice in the mouth." 

" Suitable also against toothache are fumigations made with the seeds 
of the hyoscyamus scattered on burning charcoal; these must be followed 


by rinsings of the mouth with hot water; in this way sometimes, as it were, 
small worms are expelled."^ 

This passage of Scribonius Largus has given rise to the idea that the 
dental caries depends upon the presence of small worms, which eat away 
the substance of the tooth. Such an explanation must have well suc- 
ceeded in satisfying the popular fancy; and it is for this that such a 
prejudice, although fought against by Jacques Houllier in the sixteenth 
century, has continued even to our days. 

With regard to this I would like to record the following fact: Not 
many years ago there lived in Aversa, a small town near Naples, Italy, a 
certain Don Angelo Fontanella, a violin player, who professed himself to 
be the possessor of an infallible remedy against toothache. When sum- 
moned by the sufferer, he carried with him, in a bundle, a tile, a large 
iron plate, a funnel, a small curved tube adjustable to the apex of the 
funnel, a piece of bees' wax, and a small packet of onion seed. Having 
placed the tile on a table, the iron plate was put upon it, after it had been 
heated red hot. Then the operator let a piece of bees' wax fall upon the 
red-hot iron, together with a certain quantity of the onion seed; then, 
having promptly covered the whole with the funnel and made the patient 
approach, he brought the apex of the said funnel close to the sick tooth, 
in such a way as to cause the prodigious, if somewhat stinking, fumes 
produced by the combustion of the wax with the onion seed to act upon 
it. In the case of a lower tooth, the above-mentioned curved tube was 
adapted to the funnel, so that the fumes might equally reach the tooth. 
The remedy, for the most part, had a favorable result, whether because 
the beneficial effect was due to the action of the hot vapor on the diseased 
tooth, or to the active principles resulting from the combustion of the 
wax and onion seed, or to both, or perhaps also, at least in certain cases, 
to the suggestion that was thus brought to bear upon the sufferer. It 
would not be at all worth while to discuss here such a point. The 
interesting part is that when the patient had declared that he no longer 
felt the pain, Don Angelo, with a self-satisfied smile, turned the funnel 
upside down, and showed on its internal surface a quantity of what he 
pretended to be worms, which he affirmed had come out of the carious 
tooth. Great was the astonishment of the patient and of the bystanders, 
none of whom raised the least doubt as to the nature and origin of these 
small bodies, no one having the faintest suspicion even that these, instead 
of coming from the tooth, might come from the onion seed ! 

According to Scribonius Largus, toothache might also be taken away 
by fumigations of burnt bitumen. He affirms also that great benefit 

* Suffire autem oportet ore aperto alterci semine carbonibus asperso, subinde os colluere 
aqua calida; interdum enim quasi vermiculi quidam eiciuntur. 


may be derived against odontalgia by masticating the wild mint, or the 
root of the pyrethrum, or by covering the diseased tooth with a plaster 
composed of peucedanum juice, opopanax, incense, and stoneless raisins. 
But before making use of this last remedy, he advises that the tooth and 
the gums near it should be fomented with very hot oil, by means of a 
toothpick or ear-picker wrapped around, at one end, with some wool. If 
the pain does not entirely cease, or comes on again, it is well, says the 
author, to continue the fomentations with hot oil, above the plaster, 
until the pain ceases. To strengthen loose teeth, Scribonius advises 
frequent rinsings of the mouth with asses' milk or with wine in which 
have been cooked the roots of the sorrel until the liquid has boiled down 
to one-third. Another remedy which he recommends against looseness 
of the teeth is composed of honey and alum mixed together in a mortar, 
in the proportion of two parts of the first to one of the second, and then 
cooked in an earthen vase, so as to render the mixture more homogeneous, 
and to give it more consistency. He also speaks of a third medicament, 
resulting from cooking strong vinegar, alum, and cedria* in a copper vessel 
until it has the consistency of honey. This remedy would serve not only 
to make loose teeth firm, but the author assures us also that whoever 
rubs the teeth with it, three times a month, will never be subject to dental 

Scribonius Largus gives the receipts for various dentifrice powders 
in use at that period. The skin of the radish dried in the sun, pounded 
to powder, and then passed through a sieve, would furnish a good denti- 
frice, suited to strengthen the teeth and to keep them healthy. Very 
white glass, similar to crystal, reduced to a very fine powder and mixed 
with spikenard, is also, according to Scribonius Largus, a valuable 

Octavia, sister of Augustus, used a powder which our author highly 
commends, saying that it strengthens the teeth and makes them very 
beautiful.' To prepare it, one must take a sextary' of barley flour and 
knead it well to a paste with vinegar and honey mixed together, and 
must divide the mass into six balls, each of which must be mixed with 
half an ounce of salt; these balls must then be cooked in the oven until 
carbonized; and lastly pounded to powder, as much spikenard being 
added as is necessary to give it an agreeable perfume. 

Scribonius Largus also lets us know the tooth powder made use of 
by Messalina, the wife of the Emperor Claudius; this was composed of 
calcined stag's horn, mastic of Chios, and sal ammoniac, mixed in the 

* Gum of the cedar tree. 

' Dentifricium, quod splendidos facit dentes et confirmat, chap, xi, lix. 

' A Roman measure of capacity, equal to a little more than half a liter. 


proportion of an ounce of mastic and an ounce and a half of sal ammoniac 
to a sextary of the ashes of stag's horn. 

Servilius Damocrates, a Greek physician, who acquired great 
renown in Rome toward the middle of the first century, was the author 
of many valuable works, both in verse and prose, which, unfortunately, 
have been lost. His works are mentioned by Galen, who testifies to his 
great esteem for Damocrates, calling him an eminent physician, and 
quoting various passages from his works, and among others three poet- 
ical receipts for dentifrice powders. From these receipts it appears that 
Damocrates attached the greatest importance to the cleanliness of the 
teeth, and that he considered this the indispensable condition for avoid- 
ing disease of the teeth and gums. 

Andromachus the Elder, of Crete, the physician of Nero, who con- 
ferred upon him, for the first time, the title of archiatery became famous 
through his theriacy an extremely complicated remedy, the virtues of which 
were sung by him in a Greek poem, dedicated to the Emperor. The 
theriac was considered an antidote against all poisons and a remedy 
against the greater part of diseases, in short, as a real panacea. It is 
not even necessary to remark that this portentous medicine, which has 
held a post of honor, from ancient times almost up to the present day, 
was also used against odontalgia; and in those cases in which this was 
produced by caries, Andromachus advised the filling up of the cavity 
with the electuary which he rendered so famous. As the chief basis of 
the theriac was opium, combined with stimulating and aromatic sub- 
stances, there is no doubt that its use locally or even internally would 
prove beneficial, temporarily at least, in many cases of odontalgia.^ 

Archigenes, of Apamea, a city of Syria, lived in Rome toward the 
end of the first century and at the beginning of the second, under the 
Emperors Domitian, Nerva, Trajan, and Hadrian. He acquired great 

* The origin of the theriac, according to what Galen writes in his book De antidotis, is 
to be traced back to Mithridates, King of Pontus, who lived from the year 132 to the year 
63 B.C. This king, patron of Art and Science, was, for his times, an eminent toxicologist. 
By making experiments on condemned criminals he sought to discover by what drugs the 
action of the various poisons, both mineral and vegetable, and those inoculated by the bites 
of poisonous animals might be counteracted. He afterward mixed the various antidotes 
together for the purpose of obtaining a remedy that might prove a preservative against the 
action of any poison whatever. This universal remedy, the receipt of which was carried 
to Rome by Pompey, the conqueror of that great king, was named mithriJatium, after the 
name of him who had composed it. Andromachus modified the mithridate; he took away 
certain ingredients and added others, reducing the number of them from about eighty to 
sixty-five. The principal modification was that of introducing into the composition of this 
drug the flesh of the viper ; wherefore, Galen is of the opinion that the theriac (so called 
from the Greek word theriorij a noxious animal) was more efficacious than the mithridate 
against the bite of the viper. The theriac still exists in the French pharmacopeia, although 
considerably simplified. In every 4 grams it contains 5 centigrams of opium. 


fame as a physician and as an operator, and distinguished himself partic- 
ularly by daring amputations and trepannings. He recommends various 
remedies against odontalgia, among which are mouth washes of strong 
hot vinegar, in which gall-nuts or halicaccabum* have been boiled. He 
usually introduced into carious teeth a mixture of turpentine and vitriol 
of iron (^sory {egypUuni)^ or a mixture of pepper, and oil of spikenard or 
of almonds, and this was also dropped into the ear, on the side on which 
the pain was felt. 

Archigenes, too, like other great physicians of that time, recommended 
various remedies taken from the animal kingdom against diseases of the 
teeth, which now seem very strange to us, but at that period appear to 
have been in great use. Thus, it would be of great benefit to hold in 
the mouth for some length of time a mixture of vinegar and water in 
which a frog has been well cooked. The slough of a serpent, burnt and 
then reduced, by the addition of oil, to the consistency of solidified honey, 
would be a valuable remedy, which being introduced into a carious 
hollow, and plastered all around the tooth and on the surrounding parts, 
would cause the most violent pain to cease. And, moreover, desiring 
to cause a diseased tooth to fall out, it would be enough to apply to and 
press upon it a piece of the unburnt slough of a serpent. Two excellent 
anti-odontalgic remedies to be introduced into carious hollows would 
be roasted earth-worms and spikenard ointment mixed with the crushed 
eggs of spiders. It would be also of use to drop into the ear on the side 
of the aching tooth some oil of sesamum in which earth-worms have been 

When the pain is situated in broken teeth, Archigenes advises theni to 
be cauterized with a red-hot iron. 

Against bleeding of the gums, he recommends rubbing them with very 
finely pulverized alum and myrtle and the application of astringent and 
tonic liquids. 

When odontalgia appears to depend upon an inflammatory condition, 
he advises the aching teeth to be plastered up with a mixture composed 
of red nitre, pounded peach kernels, and resin. 

Archigenes repeatedly recommends the cleaning of the teeth and of 
the carious cavities before applying to the former or introducing into 
the latter the appropriate remedies.' 

But Archigenes' principal merit, so far as concerns the art of dentistry, 
consists in his having guessed that odontalgia, in certain cases, arises 
from a disease of the interior part of the tooth (viz., from inflammation 
of the pulp) and in having discovered an excellent method for curing 

* A species of solanacear of the Physalis genus, probably the Physalis alkekengi. 
^ Galeni de compositione medicamentorum secundum locos, liber v. 


such cases. When a tooth appeared discolored, without being afFected 
by caries, and was the seat of violent pains, against which every remedy 
had proved of no avail, Archigenes perforated it with a small trephine, 
invented by himself for the purpose. He applied the instrument to that 
part of the crown which was most discolored and drilled right down 
to the centre of the tooth.^ 

Without doubt this talented surgeon was induced to adopt this method 
of cure by the idea of the existence of morbid substances in the interior 
of the tooth and by the consequent indication of giving them a free exit. 

The operation devised by Archigenes proves, among other things, two 
important facts : first, that the anatomical constitution of the teeth had 
already been explored, seeing that Archigenes did not ignore the existence 
of the pulp cavity; and secondly, that Archigenes was greatly opposed 
to the extraction of a tooth unless absolutely necessary. It might be 
thought that such aversion depended upon an exaggerated idea of the 
dangers connected with the extraction of a tooth, an idea widely diffused 
at that period; but regarding such a daring surgeon as Archigenes was, 
it is more logical to suppose that in similar cases he had recourse to 
trephining and not to extraction, especially on account of the importance 
he attached to the preservation of the tooth. 

Surgery in ancient times was eminently conservative; later on — partly 
by effect of its own progress — it became too readily inclined to the 
removal of diseased parts; in modern times it has again become what it 
wa« originally, and what it must ever be, viz., conservative in the highest 
possible degree. 

Cl-AUDIUS (lALKN, after Hippocrates the greatest physician of ancient 
times, was born at Pergamus, a city in Asia Minor, in the year 131 of our 
rr«4. His father Nicon, a man of great abilities, who was at the same 
time a man of letters, a philosopher, a mathematician, and an architect, 
had put him, at a very early age, to the study of science and of the liberal 
arts. ( Jalen began to study medicine at the age of seventeen, under the 
guidaiUT (»f skilful doctors of his native country; he made several journeys 
in ordn 10 have the benefit of the instruction of celebrated masters, and 
finally rie<|uented the renowned medical school at Alexandria. On 
g<m\B to Rome, in the thirty-fourth year of his life, he soon acquired in 
that v'itv a very high renown. He died in the first decade of the third 
v'i'miu v» but Nve ilo not know exactly in what year. 

( Jalih was a n\ost prolific writer, and his works, considering the period 
\\\ whivh thev were written, fiirm a real medical encyclopedia. Anatomy 
Ouough his researches made considerable progress, for he studied with 

^ j. K- lH(\4l, KvvhvrchfK hixtoriqucs sur Tart du dentiste chez les anciens, Paris, 1808, 


the utmost care and attention (especially in apes) the bones, muscles, 
heart, bloodvessels, brain, nerves, and every other part of the organism. 
His anatomical researches enabled him to correct many errors, but as 
he had dissected almost exclusively animals and not human corpses, he 
himself fell into several errors, especially in attributing to man parts which 
he does not possess, for example, the intermaxillary bone. 

Galen justly observed that the inferior maxilla (resulting, according 
to him, from the union of two bones, which, indeed, is embryologically 
true) has in man, proportionally to the other bones of the skeleton, a 
lesser length than in animals. 

He holds that the teeth must be enumerated among the bones, and does 
not admit any doubt to be raised on this point, as these parts can be 
looked upon neither as cartilages, nor as arteries, nor as veins, nor as 
nerves, nor as muscles, nor as glands, nor as viscera, nor as fat, nor as 
hair — a method of reasoning by elimination which is very specious but 
far too weak! 

Galen indicates exactly the number of incisor, canine, and molar teeth 
(without, however, making any distinction between small and large 
molars), and speaks of the different functions of these three kinds of 
teeth. Not always, he says, are the molars of each jaw five in number 
on each side; in some individuals there appear only four; in others six. 
The incisors and canines have but one root; the upper molars have gener- 
ally three, but sometimes, though not often, four; the lowers have for the 
most part two, rarely three. 

Galen is the first author who speaks of the nerves of the teeth. He 
says that these organs are furnished with soft, that is sensitive, nerves* 
belonging to the third pair.' The teeth, according to him, are furnished 
with nerves, both because, as naked bones, they have need of sensibility, 
so that the animal may avoid being injured or destroyed by mechanical 
or physical agencies, and because the teeth, together with the tongue 
and the other parts of the mouth, are designed for the perception of the 
various flavors.' 

In regard to odontalgia, Galen made some very important observa- 
tions on his own person: 

"Once when I was troubled with toothache, I directed my attention to 
the seat of the pain, and thus I perceived very clearly, that not only 
was the tooth painful but also pulsating, which is analogous to what 

^ Galen admits three kinds of nerves: soft or sensitive nerves, originating from the brain; 
hard or motor nerves, originating from the spinal marrow; medial nerves, motor-sensitive, 
originating from the medulla oblongata. 

' Galen distinguishes seven pairs of cerebral nerves; his third pair corresponds to the 

' Galeni de usu partium corporis humani, lib. xvi. 


happens in inflammations of the soft parts. To my astonishment, I 
had to persuade myself that inflammation may arise even in a tooth, in 
spite of the dental substance being hard and iapideous. But another 
time, when I again was attacked by odontalgia, I perceived very distinctly 
that the pain was not localized in the tooth, but rather in the inflamed 
gums. Having, therefore, suffered these two kinds of pain, I have ac- 
quired the absolute certainty that, in certain cases, the pain is situated in 
the gums, in others, on the contrary, in the very substance of the tooth." 

When a tooth becomes livid, Galen deduces from this that the tooth is 
the seat of a morbid process equivalent to inflammation. Besides, he 
says, we cannot be surprised that the teeth may be subject to a phlogistic 
process, when we consider that these, like the soft parts, assimilate 
nourishment. The teeth, by effect of mastication, are continually worn 
down, but nutrition repairs the losses, and they, therefore, preserve the 
same size. But when a tooth from want of its antagonist is consumed but 
little or not at all by mastication, we see that it grows gradually longer, for 
the very reason that under such conditions the increase due to nutrition is 
not counteracted by a corresponding waste. 

The nutritive process of the teeth may, according to Galen, be altered 
either by excess or by defect; from which arise morbid conditions, quite 
different the one from the other. An excess of nutrition produces a phlo- 
gistic process analogous to that of the soft parts; a defect of nutrition makes 
the teeth thin, arid, and weak. The first of these pathological states is 
met with especially in young men and must be fought against with the 
ordinary antiphlogistic means, designed to eliminate the excess of humors 
(evacuant, resolvent, revulsive, and astringent remedies). As to defect 
of nutrition, this is met with most frequently in old people. It has the 
effect not only of making the teeth thin, but also of enlarging the alveoli, 
from which there results a looseness of the teeth more or less noticeable. 
Against this morbid condition we do not possess, says Galen, any direct 
remedy; however, it can be combated, up to a certain point, by strength- 
ening the gums with astringent medicaments, so that they may close 
tightly around the teeth and thus make them firm. 

Dental caries is produced, according to Galen, by the internal action 
of acrid and corroding humors, that is, it is produced in the same manner 
as those cutaneous ulcers which appear without any influence of external 
causes. The cure must consist in acting upon such vicious humors by 
means of local or general medicaments according to circumstances and 
also in strengthening the substance itself of the teeth by the use of astrin- 
gents and tonic remedies.^ 

After these preliminary remarks, Galen gives a minute descr?"*^'* '^^ 

* Galeni de composttioiie rn* 


the numerous remedies which, from his own experience and from that 
of other great doctors, were to be considered useful for the cure of the 
various affections of the teeth and gums. 

Against gingivitis and the pains deriving from it, the best remedy, 
according to Galen, consists in keeping in the mouth the oil of the 
lentisk moderately warm; noting, however, that such a remedy is the 
more efficacious the more recently it has been prepared. 

A decoction of the root of the hyoscyamus in vinegar, used as a mouth 
wash, is another remedy recommended by Galen against the pains in 
the gums. It would also be of benefit to apply on the inflamed gums a 
powder composed of one part of salt to four of alum, afterward washing 
the mouth with wine or with a decoction of olive leaves. If the gums 
are ulcerated, Galen recommends them to be cauterized with boiling 
oil, using for the purpose a little wool wrapped around a probe or tooth- 
pick. This medicament, says Galen, greatly modifies the diseased part, 
exciting a reparative process in it, to aid which, however, suitable remedies 
must be used, and especially frictions with a mixture of gall-nuts and 
myrrh reduced to a fine powder. 

For the cure of epulides the application of green vitrol, together with an 
equal quantity of powdered myrtle and a little alum, is especially recom- 

In dentition, if the gums are painful, it is advisable to rub them with 
the milk of a bitch. The teeth, moreover, appear very readily, says 
Galen, if the gums be rubbed with hare's brain. 

Against odontalgia, properly so called, independent, that is, of diseases 
of the gums, Galen particularly recommends warm applications, either 
on the cheek or directly on the tooth. Externally, on the side of the pain, 
may be applied dirty (!) pieces of linen, well warmed, or else small bags 
full of roasted salt, or cataplasms of linseed or barley flour. But if it 
is desired to act directly upon the sick tooth, this may be rubbed with a 
branchoforiganum (wild marjoram) dipped in hot oil, orelse, after applying 
a bit of wax on the tooth, the heated end of a probe may be laid upon it; 
or lastly, fumigations may be made by burning the seeds of the hyoscya- 
mus. In case the above remedies, or others like them, be found of no 
use, Galen recommends them to be adopted anew after having perfor- 
ated the sick tooth by means of a small drill. But if even from this no 
benefit be derived, and it is considered well to remove the tooth, this can 
be done without pain by the application of special medicaments. Among 
these the root of pyrethrum kept in very strong vinegar for forty days 
and then pounded takes the first place. The remedy is applied after 
having well cleaned the sick tooth, and after having covered the others 
I wax. At the end of an hour the tooth will have already become 
that it can be drawn out with the fingers or with the mere help 


of a style. The same effect may be obtained, says Galen, by the appli- 
cation of blue vitriol mixed with very strong vinegar. 

To prevent a carious tooth from producing pain or fetor, he advises 
the carious hollow to be filled up with black veratrum mixed to a paste 
with honey. 

To restore to blackened teeth their whiteness, Galen advises them to 
be rubbed with special medicaments, one of which is made up of dried 
figs, burnt and pounded, with spikenard and honey. He gives, besides 
the receipts of many dentifrice powders and tinctures designed both to 
strengthen the teeth and gums and as preservatives against the diseases 
of these parts. Such powders and tinctures do not offer any interest to 
us, since they do not much differ from those recommended by other 
authors whom we have previously quoted. 

When one or more teeth, in consequence of a trauma, or from other 
cause, become loose and project above the level of the others, Galen 
removes the whole exuberant part by means of a small iron file. In per- 
forming this operation, after having covered the gums with a soft piece 
of cloth, he holds the tooth to be filed steady with the fingers of the left 
hand, using the file in such a way as not to give the tooth any shock. 
Besides, he does not complete the operation at one sitting, but rather 
interrupts it as soon as the patient feels any pain, and continues it after 
one or two days. In the meanwhile, he makes use of remedies suited 
to strengthen the loosened teeth, and bids the patient remain silent and 
nourish himself with liquid or soft food. 

When the teeth, without the action of external causes, become loosened, 
Galen holds that this is due to a relaxation of the dental nerve in conse- 
quence of an excessive abundance of humors. In such cases he counsels 
the use of desiccative remedies. 

Galen, like ancient authors in general, is not very favorable to the 
extraction of teeth with the forceps. Even he seems convinced that a 
tooth may be made to fall out, without pain, by means of the application 
of certain remedies, to which we have already alluded. However, in 
one of the Galenic books^ we find the precept already given by Celsus, 
that before extracting a tooth the gums must be detached all around; 
from which one may argue that, at least in certain cases, instrumental 
extraction was considered inevitable. Galen even alludes to the pain 
which sometimes remains after the extraction of a tooth, and is of the 
opinion that this depends upon an inflammatory condition of the stump 
of the dental nerve. 

In Galen are found recorded many means of cure, recommended by 
celebrated doctors of ancient times. Elsewhere we have already spoken j^iiiiM 

^ Medicus, chap. xix. 


of some remedies counselled by Damocrates, by Andromachus the elder, 
and by Archigenes. Apollonius, as a medicament against odontalgia, 
advised that the juice of the beet root be dropped into the nostrils, or 
else a liquid prepared from cumin seed, myrrh, cucumber, and woman's 
milk. Heraclides of Tarentum recommended against the pains and 
looseness of teeth that a vinous decoction of black veratrum, mandrake, 
and hyoscyamus root should be kept in the mouth. Criton prescribed, 
for strengthening loose teeth, that the mouth should be frequently washed 
with a vinous decoction of lentisk, myrtle, and gall-nuts. 

Celius Aurelianus. In the book De morhis acutis et chronicis^ 
written by Celius Aurelianus (who lived, according to some, in the third 
century, according to others, in the fourth or at the beginning of the fifth), 
a very interesting chapter on odontalgia is found. He shows himself to be, 
for the most part, a follower of Celsus. During the violence of the pain 
he advises abstinence from food and rest in bed with the head somewhat 
raised. As remedies he recommends several mouth washes (infusions or 
decoctions made with wine or vinegar and with various drugs: ironwort, 
acacia, mercury herb, mandrake, cinquefoil, poppy, verbascum, hyos- 
cyamus, figs, stag's horns, etc.), and besides, the application of wool 
soaked in hot oil on the cheek of the affected side, or the application of 
little warm bags, and also that some hot oil, or the juice of fenugreek,* 
should be kept in the mouth, or milk with honey. When the pain is 
excessively violent, he has recourse to bloodletting, and after two days' 
fasting, he begins to feed the patient with liquid and warm food. If the 
bowels are closed he prescribes the use of clysters, and when, in spite of 
all, the pain persists, he has recourse to scarified cuppings on the cheek, 
in correspondence with the pain. In certain cases he also proceeds to 
scarification of the gums, or else he detaches them all around from the 
tooth, by means of a special instrument called a peri character. It would 
often turn out useful to apply to an aching tooth a grain of incense warmed 
by the fire and wrapped in a thin piece of cloth, or to press between the 
teeth, where the pain is situated, several pieces of cloth, in succession, in 
which some powder of incense has been wrapped, and which are dipped 
into hot oil before being used. The author, moreover, commends ex- 
ternal fomentations made by means of sponges soaked with emollient 
decoctions and afterward squeezed; and also the application of moder- 
ately hot cataplasms. 

When the odontalgia has already become inveterate and recurs in 
paroxysms, separated by intervals of calm, Celius Aurelianus counsels, 
among other things, that the general health be strengthened by temperate 
^"^^%f exercise, rubbing of the whole body (an ancient practice, now 

Tfigonella foenum graecum, a papilionaceous plant. 



revived under the name of massage). He recommends, besides, special 
rubbing of the cheeks (to be carried out with a rough cloth), and also of 
the gums and teeth, and indicates a great number of medicaments, some 
of which are to be used during the paroxysms and others during the 
periods of calm. In regard to the use of narcotics, he very shrewdly 
obser>'e8 that such remedies take away sensibility but not pain. Some 
doctors of those days, for the cure of odontalgia, had recourse to sternuta- 
tories, or to the dropping of special medicaments into the nose or into the 
ear, but Celius Aurelianus seems to have put but little faith in such 
means of cure. He, moreover, solemnly reproaches those who, to cure 
rxlrmtalgia, are too hasty in having recourse to the extraction of the aching 
cooth. To remove a part, says he, is not to cure it; and if every tooth 
that aches has to be extracted, it would be necessary to draw them all 
out when they all ache. Therefore, before having recourse to extrac- 

^'G- a 

Xtmi'dti dtnvA forceps found (1894) at Hamburg, Germany, in the ancient 

Roman castle Saalburg. (Geist-Jacobi.) 

tion, tytry other means of cure should first be tried. If the removal of 
the trxnh becomes indispensable, he advises that it should never be per- 
formed during the violence of the pain, for from this serious consequences 
might arise fa prejudice which has not ytt entirely vanished, and which 
is met with, s^>metimes, not only among common people, but even among 
physicians); and a still greater danger would be the extraction of teeth 
neither carious nor Ux>se, seeing that, by consensus, the muscles, the eyes, 
and the brain might suffer. The author, on this point, quotes Herophilus 
and Heraclides of Tarentum, who related some cases in which the 
extraction of a tooth was followed by death. He alludes, moreover, 
to a passage of Krasistratus, regarding the "odontagogon of lead'* 
(plumbeum odontagogum) which was exposed in the temple of Apollo 
at Delphi; as much as to show that it was not lawful to extract teeth 


other than those which were so loose that an instrument of lead was 
sufficiently strong to extract them. 

When the looseness of the teeth seems to depend upon the flaccidity 
of the gums, Celius Aurelianus recommends astringent mouth washes: 
decoctions of rind of pomegranate, of gall-nuts, of acacia, of quince, of 
myrtle berries, etc. ; and besides these, lentiscine oil and asses' milk, 
which latter was also believed to possess astringent virtues. Against 
hemorrhages of the gums, he advises the use of very fine coral powder, 
or of alum with honey. 

Gnaeus Marcellus Empiricus, of Burdigala (Bordeaux), who lived 
at the end of the fourth century and at the beginning of the fifth, wrote 
a book, De medicamentiy which shows, more than anything else, the deca- 
dence of the medical science in those days. Regarding the diseases of 
the teeth and their cure, Marcellus does not tell us anything new. He 
freely copies Scribonius Largus and other authors, not adding anything 
save a few methods of cure, which are exceedingly strange and super- 
stitious. To get rid of toothache, it is sufficient that the patient, when 
the moon is waning, and in the days of Mars (Tuesday) or of Jupiter 
(Thursday), repeat seven times the words argidaruy margiJaniy siurgidam. 
It is a great pity that a curative method so simple and easy be efficacious 
in two days of the week alone, and even then on condition that the moon 
be waning. 

The following method is also a very good one: Whilst in the open 
country, one must take a frog by the head, open its mouth and spit into 
it, then having begged the animal to take the toothache with it, must 
replace it on the ground and let it free. To remove loose teeth easily, 
it is necessary to keep in reserve some juice of black ivy mixed with a 
little green oil ; in case of necessity, the nose of the patient must be 
anointed with it, and after having drawn a deep inspiration, he must put 
a little stone between his teeth, and stay with his mouth open, inclined a 
little forward, so as to let all the morbid humor flow out, which sometimes 
flows very abundantly and even may reach to three herminae.* Having 
afterward rubbed the nose with pure oil, and washed the mouth with wine, 
the teeth will be free from every pain and may be very easily pulled out. 
If the root' of a tooth be rubbed with dried African sponge, the tooth 
will fall out within three days; naturally, says the author, care must be 
taken not to touch, whilst doing this, any healthy tooth. He who desires 
never to be subject to pain in the teeth, may obtain this end by the fol- 
lowing method : When at the beginning of spring he sees the first swallow, 
he must go in silence to some running water, take some of it in his mouth, 
rub his teeth with the middle fingers of both his hands, and say: ^^Hirundoy 

* [About twenty-eight fluidounces. — E. C. K.] 

' Under the name of rooi, the ancients meant also the neck of the tooth. 


it hi dtcOy quomodo hoc tn rostro iteriim tjoh erit^ sic mi hi denies non doleant 
toto anno.^^^ 

The same must be done each following year, so as to continue to enjoy 
the effects of such a cure! 

Adamantius, an Alexandrine philosopher and physician, who prob- 
ably lived in the fourth century, paid much attention to the diseases of 
the teeth, as may be argued from two chapters of the Tetrabiblos of 
^tius. One of these chapters is entitled, according to the Latin trans- 
lation of Giano Cornario: **Cura dentium a calido morbo doloroso 
affectorum, ex Adamantio, sophista."* This writer clearly belonged to 
the pneumatic school founded as early as 69 a. d. by Athenaeus of Cilicia. 
According to the pneumatics (so called, because they admitted the exist- 
ence in the animal organism of an aeriform principle, pneumay to which 
they attributed great importance), heat and dryness gave rise to acute 
maladies; the phlegmatic affections generally arose from humidity, and 
melancholy was brought on by cold and dryness, as every object dries up and 
becomes cold on the approach of death. The author says that the cure 
must vary according as the disease affects in a greater degree the gums 
or the teeth themselves with or without participation of the dental nerves 
and neighboring parts. He makes, in regard to this, many subtle dis- 
tinctions; but the remedies which he counsels do not offer to us any special 
interest, being almost identical with those that had been recommended 
by Galen and by other doctors prior to Adamantius. The latter also 
gives much importance to dietetic therapy; he prescribes that such patients 
should nourish themselves with pottages of barley, or of spelt, with eggs, 
lettuce, pumpkins, and other cooling food, abstaining, however, from 

The author enumerates among the causes of such dental affections the 
dryness of the air, the autumnal season, the dry constitution of the indi- 
vidual, a troubled life, and scanty nourishment. The use of sour and 
piquant substances is not favorable to these patients, so much so that 
the mulberry preserve produces, not unfrequently, violent dental pains 
in them. Adamantius, therefore, advises, in such cases, not to use 
strongly astringent mouth washes, but rather lenitive, moistening, and 
emollient substances; simple lukewarm water, decoction of bran, licorice 
juice, starch with boiled must of wine diluted with warm water, milk, 
especially asses' milk, decoction of mallows and the like.* 
\ The work of Adamantius from which .-^tius has taken the above- 
mentioned chapters is lost to us. Of his writings there only remain to 

' Swallow, I tell thee, as this water will not be again in my mouth, even so my teeth will 
not ache for the whole year. 

- The cure of teeth affected by warm painful disease; according to Adamantius the sophist. 
^ J¥a\\ tetrabibl., ii, sermo iv, cap. xxvii. * Ibid., cap. xxxi 


us the treatise on the winds and the one on physiognomies. In this latter 
book the author attributes great importance to the canine teeth as physiog- 
nomonic elements^ and from their shape and size he makes deductions 
in regard to th^ character of the individual. 

Oribasius (316 to 403), the most celebrated of all the compilers 
who appeared during that long period of decadence, wrote, by order of 
the Emperor Julian the Apostate, whose physician and friend he was, a 
whole medical encyclopedia and later on a summary (synopsis) of this 
same work of his. In the books of Oribasius are found many things 
about dentition and diseases of the teeth, but they are all taken, sub- 
stantially, from preceding authors, and therefore it is not worth while 
repeating them. 

^Tius OF Amida, a celebrated Greek writer on medicine, lived at the 
end of the fifth century, and at the beginning of the sixth, and has also 
left us a kind of medical encyclopedia, which, being divided into four 
sections, each composed of four books, was called Tetrahihlos. He 
teaches that the mucous membrane of the gums, tongue, and mouth is 
provided with nerves from a portion of the third pair of cerebral nerves, 
and that the teeth, too, by a small hole existing at the end of every root, 
receive tiny ramifications of sensitive nerves, having the same origin. 
The nutrition of the teeth is understood by £tius in the following way: 
The nourishment which reaches the dental nerves is not entirely assimi- 
lated by them; these only appropriate the liquid or soft part and reject 
the drier part. This accumulates in the alveoli, becomes by degrees 
more tenacious and denser, finally being transformed into osseous sub- 
stance and forming the nutriment of the teeth; these, therefore, tend to 
grow continually, although the waste arising from the mechanical action 
of mastication prevents them from undergoing any real or visible growth. ' 
On the other hand, in the old, from the weakening of the nutritive 
functions, the teeth become thin and loose, and finally fall out.^ 

£tius advises that during dentition hard objects to chew should not 
be given to children, seeing that the gums being hardened by. these 
and becoming almost callous would render the cutting of the teeth very 

For curing parulides, he reco nmends emollients at the beginning of 
the disease, and later on astringents. But if the inflammation of the 
gums does not resolve and passes into suppuration, he prefers to perform 
the excision of the parulis, instead of making a simple incision, which 
might very easily cause the abscess to change into a fistula.' 

The epulis, according to £tius, is a fleshy excrescence of the gums, 
brought on by inflammation. To cure it, he uses, during the inflammatory 

' JEui tetrabibl., ii, sermo iv, cap. xix. ' Ibid., i, sermo iv, cap. ix. 

' Ibid., ii, semio iv, cap. xxiv. 


pcriocL emoUieiits* and then, when the uiflanmuraon has subsided, 
tiingcms and weak caustics. Lastly, if the epulis resist these remedies, 
he takes hold of it with a vulsella and proceeds to remove it with a smaO 

When the incision of a fistula of the gums and the use of appropriate 
remedies are not sufficiem for curing it, jEtius advises the extraction of 
the diseased tootlu from which the fistula has its origin.' 

Apart from what has been mentioned, JEtius does not tell us, in regard 
to dental diseasri, anrthii^ worthy of note, and in manv places he onlv 
repeats Galen's observations. 

Paul of Sxa^x (seventh century- > establishes a ven- dear distinction 
between epulis and parulis. The epulis is a fleshy excrescence of the 
gums in the neighborhood of a tooth; the parulis is an abscess of the gums. 
To cure the former affection it is necessari". says the author, to sieze 
and stretch the tumor with a vulsella or with a hook and to perform its 
excision. As to the parulis, although not unfrequently it is sufficient, 
for curing it, to giire an exit to the pus by means of a slight incision, the 
author, however, usually prefers the method of cure recommended bv 
.Etius, viz., excision. .After such operations he orders the patient to 
rinse his mouth with wine and on the morrow with hydromel.' From the 
third day onward he sprinkles the wound with a cicatrizing powder, 
until a complete cure is obtained. But if the wound, instead of healing, 
be transformed into a putrid ulcer resisting all the ordinari' means of 
cure, it is necessari' to cauterize the part affected with an ovat-shaped 

In extracting a tooth, the operation is begun by detaching the gum all 
around it as far as the alveolar border; then the tooth is seized with 
the forceps, shaken loose, and drawn out. Paul of .£gina, like Celsus, 
recommends that before extracting a tooth deeply attacked by caries, 
the caviri' be filled up with lint, in order to avoid the crumbling of the 
tooth under the pressure of the instrument. On the other hand, he too 
is convinced that a diseased tooth can be made to fall out without pain, 
bv the use of suitable remedies. 

\Mien supemumerar} teeth cause an irregularity of the dental arches, 
this must be corrected, says the autlK^r. either by resection of such teeth, 
if thev are ven* firm, or by their extraction. 

If a tooth projects above the level of the others, the protruding part 
must be removed with the file. This instrument must alsao be emplo\ed 
to remove the sharp edges of broken teeth. 

- TctrabibU ii, scnno h, cap. \x%. '" IW., cap, vv\i. 

< [The aorfior qnoied directs hf-dromcl to be made ftoai one pan ot~ honex and e^*hi 
pans of wanr bofled and] ii bas oeased lirodui^ — E. C. K.] 
^ hdi JBflBdtar de ic acdica, fih. «i capL 


Tartar incrustations must be removed either with scrapers or by means 
of a small file.* 

During the period of dentition one must not give children any food 
which requires mastication, and to soften the gums they must be anointed 
with hen's fat or with hare's brain. ^ 

To preserve the teeth and to keep them healthy, Paul of iEgina recom- 
mends all tainted food to be avoided, and also all possibility of indiges- 
tion and frequent vomitings; the use of very hard or glutinous food or of 
such as may easily leave a residuum between the teeth, for example, 
dried figs, and likewise very cold food and such as set the teeth on edge. 
He also advises that hard things should never be broken with the teeth 
and that the latter be carefully cleaned, especially after the last meal of 
the day.' 

Paul of iEgina also belongs to the class of compilers; but in utilizing 
the writings of the great physicians who had preceded him, he gives 
evidence of exquisite good sense, and not infrequently subjects the asser- 
tions of his predecessors to an intelligent and enlightened criticism. 
Besides, he inserts here and there observations and experiences of his own 
that are not without interest. He has always been, and rightly so, con- 
sidered one of the greatest physicians of ancient times, the great reputa- 
tion which he justly held among the Arabs contributing not a little to his 

This author is the last of the Byzantine period, and with him, therefore, 
we must close the earlier part of the history of dentistry. If, before 
passing to the middle period, we cast a glance over the ground already 
traversed, it is easy to perceive that dental art, in ancient times, reached 
its highest degree of development at the time when the Roman civiliza- 
tion was in its greatest splendor, when, in the capital of the world, wealth, 
luxury, and the refinements of social life marvellously increased its 
needs, and by this also gave an impulse to the evolution of all human 
activity. But ancient civilization, after having reached its culminating 
point, soon fell into decadence, and this necessarily would result in a 
hindrance to the development of dental art. From the days of Archi- 
genes right up to those of Paul of iEgina, dentistry did not make the 
least progress; indeed, as far as prosthetic dentistry is concerned, there 
was probably a retrograde movement, it being very likely that when Italy 
was subject to the dominion of the barbarians and when Christianity 
— ^which but recently had asserted itself — was strongly imposing on the 
human mind a deep contempt for all that regarded the welfare and beauty 
of the human body, no one could, any longer, think of artificially repairing 
the losses sustained by the dental system through disease or injury. 

' Lib. vi, cap. xxviii. ' Ibid., cap. ix. ^ Ibid., cap. xxix. 





The religious fanaticism excited by Islamism, transformed the obscure 
and nomad inhabitants of Arabia into a conquering nation, who very 
soon extended their power over a considerable part of Asia, Africa, and 
Europe. Spain, invaded by the Arabs in 711, fell almost entirely into 
their hands. After having by force of arms rendered themselves power- 
ful and dreaded, the Arabians acquired also great fame by the culture of 
art and science within the limits allowed them by their religious code ; 
and in these, for more than four centuries, they maintained an incon- 
testable preeminence. 

Unfortunately, as the Koran most absolutely prohibited the dissection 
of dead bodies, all serious anatomical research was thereby rendered 
impossible. This was a very great hindrance to the progress of anatomy, 
of physiology, and, in consequence, of the whole of medical science. The 
Arabians certainly had the merit of keeping alive the study of medicine 
in an age of decadence and barbarism; but, apart from the important 
progress realized by them in chemistry and pharmacology, it may be 
affirmed that the Arabs contributed but scantily to the development of 
the healing art; they followed almost entirely in the footsteps of Galen 
and other ancient, and especially Greek, authors. 

One of the characteristics of Arabian medical art consists in the aver- 
sion to bloody operations and in the effort to avoid them. A like ten- 
dency shows itself also in the sphere of dentistry; the Arabians, even 
more than their Greek and Roman predecessors, were reluctant to extract 
teeth, and employed all possible means, in order to avoid the operation. 

Rhazes (or more precisely, Abu Bekr Muhammed ben Zacarja er 
Rhazi) was born in Persia toward the middle of the ninth century, and 
gave himself up to the study of medicine when about thirty years of 
age, having previously been a musician. He wrote many works which. 


unfortunately, have, for the most part, been lost. Rhazes did not have 
recourse to the extraction of teeth, save as a last resource when every 
other attempt at cure had proved useless ; which method would no doubt 
have deserved high praise, had the author been inspired by the principles 
of conservative surgery, rather than by unjustifiable fears. Caries of 
the teeth is, according to him, identical with that of the bones. To 
hinder its progress and propagation to the neighboring teeth, he advises 
the carious cavity to be filled with a "cement" composed of mastic and 
alum. We have here a laudable attempt at permanent stopping of 
decayed teeth, although it is clear that the duration of such stopping, 
owing to the nature of the materials employed, could not be a long one. 
Furthermore, he counselled the patient to abstain from the use of acid 
food or drink and to rub the teeth with powder of gall-nuts and pepper. 

To strengthen loosened teeth, he recommended astringent mouth washes 
and sundry dentifrice powders. Others, partly taken from Galen, are 
recommended by him for prophylactic purposes and for cleansing and 
beautifying the teeth. 

Against periodontitis and the pains produced by it, he sometimes 
had recourse to bleeding. He commended, besides, opium, oil of roses, 
pepper, and honey, and also the scarification of the gums and the appli- 
cation of a leech. If, however, these remedies did not succeed, he applied 
his theriac, which was composed of castoreum, pepper, ginger, storax, 
opium, and other ingredients, to the roots of the teeth. If even this method 
of cure failed, he touched the root of the diseased tooth with a red-hot 
iron, or sought to provoke its fall by the use of special medicaments, 
such as coloquintida and arsenic (a substance to which he had recourse, 
particularly in those cases where there was ulceration of the gums). 
It is no wonder that such means of cure would sometimes produce, as 
a final result, the actual falling out of the tooth; and this, as is natural, 
served to strengthen the belief that the same result could also be obtained 
with less energetic remedies, but which were supposed to be equally 
endowed with expulsory virtues. 

Rhazes relates an interesting case of regeneration of a whole lower 
jaw; he, however, observes that the newly formed osseous mass was 
less hard than the original bone.* 

Ali Abbas, another great Persian physician (who died in 994), wrote 
a lengthy treatise on theoretic and practical medicine, one chapter of 
which is dedicated to the diseases of the teeth. When a molar tooth is 
affected by caries, and the pain cannot be subdued in any other way, 
Ali Abbas applies, inside the carious cavity, the end of a small metallic 
tube, into which he repeatedly introduces red-hot needles, leaving them 

' Rasis opera, Venedis, 1508. 


in the tube until quite cooled. Should even this have no effect, he tries 
to provoke the fall of the tooth by the application of asses' milk, with 
assafetida, or, finally, extracts it.^ 

He cures epulis, like Paul of iEgina, by excision. As to parulis, or 
abscess of the gums, he opens it with a lancet or a wooden stylus. 

When the dental arch is deformed by the existence of supernumerary 
teeth, he removes these with an instrument in the shape of a beak.^ 

Serapion (Jahiak Ebn Serapion), who lived in the tenth century, 
and up to the beginning of the eleventh, contributed but slightly to the 
development of medicine and dentistry, as he was in his writings little 
more than a mere compiler. He indicates with great precision the number 
of dental roots, and expresses an opinion that the upper molars have need 
of their three roots in order to keep firm in spite of their pendent position, 
whilst two roots alone are sufficient to keep the lower molars in place, on 
account of the support which they receive from the jaw. Serapion, like 
Galen, admits the nutrition and continual growth of the teeth — a growth 
which is produced in the same proportion as the waste due to mastication 
— and he too makes the dental diseases depend upon an alteration in the 
nutritive process, either by excess or by defect. 

Against dental pains of phlogistic origin, he recommends bloodletting, 
purgatives, and many local medicaments, reproduced in great part from 
Rhazes. In cases of persistent odontalgia due to caries, he advises, as 
an excellent remedy, the application of opium in the carious cavity. To 
strengthen loosened teeth, he first employs astringents, and if these are 
of no use, as often happens in the old, he binds the loose teeth together 
and to the neighboring healthy ones, by means of gold or silver wire. 

In Serapion, too, we find many formulas for dentifrice powders, some 
of which are intended simply for cleaning the teeth, others for special 
prophylactic or curative purposes.' 

AvicENNA. One of the greatest luminaries of medicine among the 
Arabs was Avicenna (Ebn Sina). He was born in 980 son of a high Persian 
functionary; he lived a very adventurous life, held some very high places, 
and died in 1037. Among his works, the most important is the Canoriy 
2L book which procured him the title of "second Galen" and the still 
more pompous one of "prince of doctors." A very evident proof of the 
immense fame which he acquired is the fact that among many oriental 
peoples Avicenna, even in our own days, is considered the greatest 
master of medicine. 

The anatomy and physiology of the teeth are treated by Avicenna 
very minutely, but nevertheless he does not teach us, in regard to these, 

* Haly Abbas Pract., lib. v, cap. Ixxviii. * Ibid., cap. xxxiii. 

' Serapionis practica, Venetiis, 1503. 


anything new. Like Galen, Avicenna admits that the teeth continually 
grow, and as a proof he gives the fact of the lengthening of the teeth> 
which, owing to the absence of antagonists, are not subject to any 
pressure or friction. 

He gives much good advice with regard to the preservation and cleanli- 
ness of the teeth, to which he attaches very great importance; and on this 
point he remarks that the use of very hard tooth powders must be avoided, 
as these are liable to injure the dental substance. To this latter are also 
harmful, says the author, some narcotic remedies, employed against 
odontalgia. Burnt hartshorn is, according to him, a most valuable 
dentifrice. To remove tartar from the teeth, he indicates many remedies, 
and especially dentifrices of meerschaum, salt, burnt shells of snails and 
oysters, sal ammoniac, burnt gypsum (plaster of Paris), verdigris with 
honey, etc. Among the substances able to facilitate dentition, he enumer- 
ates several oils and fats, besides the brain of the hare and the milk of 
the bitch, and he disapproves the custom of giving to children, during 
dentition, hard objects to chew, in the erroneous belief that the biting 
of such objects is useful in facilitating the cutting of the teeth; he recom- 
mends, instead, the gums to be rubbed with the fingers. When the teeth 
begin to appear, he drops some oil into the ears of the child and covers 
its head, neck, and jaws with a plaster spread on cotton that has been 
soaked in oil. 

Avicenna minutely examines the various causes of odontalgia, and 
among them includes also the little worms by which the dental substance 
was supposed to be gnawed away. 

When a tooth becomes the seat of intense pain, accompanied by a throb- 
bing feeling, Avicenna considers that this is due to an excessive accumu- 
lation of humors in the root; he therefore advises, as already Archigenes 
had done, the tooth to be drilled, in order to empty it, and afterward 
to introduce into it appropriate remedies. 

According to Avicenna, he who has a loosened tooth and desires to 
make it firm again, must avoid using it in mastication, must not touch it 
with the fingers, nor move it with the tongue ; besides this, he must speak 
as little as possible, and make use of astringent remedies. 

To remove a tooth, Avicenna made use of either the forceps or the 
"eradicating remedies," in which he, too, had full confidence. Like 
the greater part of his predecessors, Avicenna is of the opinion that 
the extraction of a firm tooth must be avoided as much as possible, as 
it may give place to an injury of the jaw, or become harmful to the visual 
organ, or bring on fever. On this point he remarks that, if an aching 
tooth appears to be sound, it is not always necessary to perform its ex- 
traction in order to cause even the most rebellious odontalgia to cease ; 
in certain cases he obtained a complete cessation of the pain after having 


simply shaken the tooth without completing its extraction; which accord- 
ing to him was due to the double reason that by shaking the tooth a 
resolution of the morbid matter stagnating under it is provoked, and the 
action of the medicaments that are afterward made use of is thus favored. 

Among the eradicating remedies, the author enumerates white arsenic, 
orpiment, coloquintida, tithymallus, the fat of frogs, and others. He 
remarks, however, that before using them it is advantageous to detach 
the gum all around. 

Against the supposed worms in carious teeth, he praises fumigations 
made with the seeds of the hyoscyamus, garlic, or onion. 

Arsenic is used by him not only for the above-mentioned purpose, 
but also for the cure of fistulas and foul ulcers of the gums. 

When a tooth has become abnormally long, Avicenna makes use of 
the file to reduce it to a proper size; and in performing such an operation, 
he holds the tooth firmly between the fingers, or with a pair of pincers 
suited for the purpose. As a consecutive treatment, he prescribes frictions 
with alum, laurel berries, and aristo lochia.^ 

Abulcasis. Among the Arabian authors, he who has the greatest 
importance in regard to dental art is undoubtedly Abulcasis (Abul- 
Casem-chalaf-ben-Abbas). Whilst Avicenna was one of the greatest 
physicians, Abulcasis was one of the greatest surgeons; and very justly 
he has been called the genius of Arabian surgery. 

Abulcasis had his birthplace in Alzahra, a small Spanish village, five 
miles from Cordova; from this he derived the name of Alzaravius, by which 
he is also known. Historians are not agreed upon the date of his birth. 
According to the most probable opinion, he was born about the year 
1050 and died in 11 22 at Cordova, a city which, on account of its cele- 
brated school, was then a most important centre of scientific and literary 

Among the works of Abulcasis, the one which brought him the greatest 
fame was the treatise De Chirurgia, It is divided into three books, in 
the first of which he speaks of all the diseases which can be treated 
by cauterization; in the second are described all the operations which 
are performed by cutting, perforating, or extracting (wherefore, obstetrics 
is also included in this book); in the third, lastly, the author treats, region 
by region, of fractures and luxations. 

Chapters XIX, XX, and XXI of the first book have reference to dis- 
eases of the teeth and gums. As these chapters are very short, we are 
pleased to give here an almost literal translation of them: 

"When in the lower part of the gums, or in the palate, there appears 
a little tumor, which afterward becomes purulent and opens and changes 

* Avicennae opera in re meJica, Venetiis, 1564. 


into a fistula, against which no medical remedy is of any use, it is necessary 
for thee to take a cautery corresponding in size to the aperture of the 
fistula, and after having heated it, to introduce it there and to keep it 
applied there until the cauterizing iron reaches the bottom of the said fistula 
and beyond. This thou shalt do once or twice, and then shalt use fitting 
medicaments until a complete cure is obtained. This is attained when 
suppuration ceases. Otherwise one cannot do less than uncover the bone 
and extract that part of it which is diseased."* 

"When through excess of moisture the gums become flaccid, the teeth 
loose, and of no use are the remedies employed by thee, thou shalt lay 
the patient's head on thy lap, and after having applied to the tooth, 
where it borders on the gum, the end of an appropriate little metal tube, 
in this thou shalt quickly introduce the cautery of which mention will be 
made in the following chapter; and thou shalt prolong the application 
as long as suffices to let the patient feel the heat right in the root of the 
tooth. This thou shalt repeat as often as thou shalt think necessary • 
Then the patient shall keep salt water in the mouth for an hour. By 
eflFect of such a cure, the corrupted moisture will dry up, the gums will 
regain their tone, and the tooth its firmness."* 

**When toothache depends upon cold, or if there exist some worm 
in the tooth, and the medicaments are of no use, recourse must be made to 
cauterization, which in such cases may be performed in two ways, viz., 
either by means of butter or with a cautery. Desiring to use butter, 
some of it must be warmed in an iron or copper spoon; a little cotton 
must then be wrapped around the extremity of a probe, dipped into the 
boiling butter, and then immediately applied to the tooth, keeping it 
there in contact until it has cooled. This must be repeated several times, 
so that the action of the heat reaches right down to the root of the tooth. 
If thou preferest, thou canst use cold butter, applied to the aching tooth 
by means of a little tuft of wool or cotton, upon which thou shalt lay a 
red-hot iron; prolonging the application of this until the heat has reached 
the very root of the tooth. 

"To perform the cauterization directly with the iron, thou must first 
rest on the tooth a small tube of iron or copper, designed to preserve the 
neighboring parts from the action of the heat, and which must, therefore, 
be of sufficient thickness. Through such a tube thou shalt apply on the 
tooth a cautery of the shape given here below, and shalt keep it there 
until it is cooled. This thou shalt do several times. The pain will 
cease the same day or on the morrow. It is, however, necessary that 

^ Abulcasis de Chirurgia, lib. i, cap. xix, p. 47; Latin translation by Channing with the 
Arabic text in front, Oxford, 1778. 
^ Cap. XX, p 47. 



after the cauterization the patient should keep his mouth, for an hour, 
full of good butter. The shape of the cautery is as follows (Fig. 34): 
Thou canst perform the cauterization with one or other of its two extrem- 
ities, as is most convenient."* 

In regard to epulis, Abulcasis prescribes that after catching hold of 
the little tumor with a hook or a vulsella its complete excision should 
be performed. This done, one must wait awhile, until the hemorrhage 
ceases, and then either a little "zegi" pulverized,^ or other drying and 
styptic powder, must be applied on the part. If the epulis recurs, which 
very often happens, the excision must be repeated and this followed by 
cauterization, since after this latter the evil will not return.' 

Abulcasis is the first author who has taken into serious consideration 
dental tartar and who has recommended that a scrupulous cleansing of 
the teeth should be performed. The chapter relating to this, *'On the 
Scraping of the Teeth," is very interesting and is worthy of being here 

Fig. 34 

Abulcasis' dental cautery and the tube through which it was applied, in order to preserve 

the neighboring parts from the action of the heat. 

''Sometimes on the surface of the teeth, both inside and outside, as well 
as under the gums, are deposited rough scales, of ugly appearance, and 
black, green, or yellow in color; thus corruption is communicated to the 
gums, and so the teeth are in process of time denuded. It is necessary 
for thee to lay the patient's head upon thy lap and to scrape the teeth 
and molars, on which are observed either true incrustations, or something 
similar to sand, and this until nothing more remains of such substances, 
and until also the dirty color of the teeth disappears, be it black, or green, 
or yellowish, or of any other color. If a first scraping is sufficient, so 
much the better; if not, thou shalt repeat it on the following day, or even 
on the third or fourth day, until the desired purpose is obtained. Thou 
must know, however, that the teeth need scrapers of various shapes and 
figures, on account of the very nature of this operation. In fact, the 
scalpel with which the teeth must be scraped on the inside is unlike 

' Cap. xxi, p. 49. ' Zegi was the name given by the Arabs to blue vitriol. 

^ Lib. ii, cap. xxviii, p. 181. * Lib. ii, cap. xxix, pp. 181 to 183. 


that with which thou shalt scrape the outside; and that with which thou 
shalt scrape the interstices between the teeth shall likewise have another 
shape. Therefore, thou must have all this series of scalpels ready 
if so it pleases God."^ 

The work of Abulcasis is, so far as we know, the first book in which are 
found figures of dental instruments. We do not know, however, how 
far such figures are exact, that is, to what degree of faithfulness they 
represent the instruments which Abulcasis really employed as the original 
figures of the book of Abulcasis were copied and recopied by successive 
transcribers of the work. And that such copies have been very often 
unfaithful may be deduced from the fact that not unfrequently figures of 
surgical instruments are found in the book which do not at all agree 
with the verbal description which the author gives of such instruments. 

In the edition by John Channing, we find at the end of the chapter 
on the scraping of the teeth two series of figures. The first series is 
found under the Arabic text, and is composed of the fourteen figures 
reproduced as Fig. 35 ; the other series, existing under the Latin text, 
has only twelve figures, as shown in Fig. 36. 

As Channing has made his translation from two diflferent Arabic copies 
of Abulcasis,* among the corresponding figures of which there exists a 
very notable difference, he, for the greater part, had to follow the plan of 
reproducing the figures of both codices. But besides this numerical differ- 
ence, there is also a considerable difference in the shape of the instruments 
represented. We must, therefore, ask ourselves which of the two series of 
figures is to be regarded as the more faithful representation of the instru- 
ments used by Abulcasis. Most probably the first series. In it we find 
figured some scrapers which have a certain resemblance to those actually 
in use; besides this, the figures of the first series seem to be drawn with 
greater accuracy than those of the second. Among other things it may 
be noticed that the handle of each instrument (excepting the last two) 
is furnished with a row of prominences, which, it is almost certain, were 
designed to afford a better grip in holding the scrapers during the 

We now consider the chapter on the extraction of teeth.' The author 
begins by saving that it is necessary to use all possible means to cure an 
attack of odontalgia, and to be very slow in deciding to extract a tooth, 
as this is a very noble organ, the want of which cannot in any way be 
perfectly supplied. When there is no way of avoiding extraction and the 

* This great Mahommedan surgeon was, it seems, ver>' religious. His book begins with 
the words: **ln the name of the merciful God, Lord perfect in goodness," and almost 
every chapter ends with **If God so wills," and the like. 

' These two manuscript codices are found in the Bodleian Library- at Oxford. 

* Lib. ii, cap. xxx, p. 185. 



patient is obliged by pain to submit to this, it is necessary first to ascer- 
tain which is the aching tooth, as very often the pain deceives the patient. 


Fig. 35 

A A/WV-AJ^. AV- ZUkj\A /VA 



.AuA^A A A iA A A A A 


A-A.^. A A A A A A. 

/\ , A>\y\AA >v A>vy\AA A 


A A. A A^A A A A A A 




A A A- A A A A 

/\ /\ A A y^ 

A-A^..,A A A A-A.^A-Af) 

A-ZV-A,A A A ^ ^ ^^ ^^^-^^Vy\ 





Set of fourteen dental scrapers (Abulcasis). 



so that he may indicate as the seat of the pain another tooth which is 
perfectly sound, and desire it to be extracted; after which, naturally, the 
pain does not cease, if not when the diseased tooth is also extracted, as 

Fig. 36 



Twelve dental scrapers as represented in another manuscript codex of Abulcasis. 

often happens in the hands of the barbers.* The aching tooth having been 
well ascertained, it is necessary to detach the gum from the tooth, all 

* The Arabic word used by the author means more precisely "those who apply cupping 
glasses." Channing has translated it by tonsoresy barbers. 


around, with a sufficiently strong scalpel. Then either with the fingers 
or with a light pair of forceps the tooth'must be shaken very gently, until 
it is loosened. Then the surgeon, keeping the head of the patient firmly 
between his knees, applies a stronger pair of forceps and extracts the 
tooth in a straight direction, so as not to break it. If it is not possible to 
draw it out, one of those elevators must be taken which the author advises 
for the extraction of roots (as may be seen afterward), and by insinuating 
it under the tooth the surgeon must endeavor to extract it. When the 
tooth is corroded and hollow, it is necessary to fill the cavity with lint, 
compressing it hard inside with the end of a probe,* so that the tooth may 
not break under the pressure of the instrument. In all cases, the operator 
must take great care not to break the tooth, for if this happens the re- 

FiG. 37 

Fig. 38 

Forceps for loosening the tooth previous to extraction (Abulcasis). 

maining part will give the patient still greater suffering. It is necessary, 
therefore, to avoid acting like the ignorant and foolish barbers, who in 
their temerity do not observe any of the above-mentioned rules, and 
therefore very often cause the patients great injuries, the least among 
which is the breaking of the tooth, the root being left in the socket, or 
else the taking away, together with the tooth, of a piece of the maxillary 
bone, as the author often happened to see. After the extraction the 
patient must rinse his mouth with wine, or with vinegar and salt. If, 
as often happens, hemorrhage is produced, a little powdered blue vitriol 
must be applied inside the wound; and if this is not sufficient, the part 
must be cauterized with a red-hot iron. 

The small forceps (Figs. 37 and 38) to be used in loosening the tooth 
must have the handle shorter than the jaws and be sufficiently strong 
not to bend when pressure is put upon the tooth. 

The large forceps (Figs. 39 and 40) with which the extraction must 

* An advice already given by Celsus. 


be performed should be made of very good Indian or Damascene iron, 
and have the handle longer than the jaws; these, moreover, on the inside 
must be toothed, or striated after the manner of files, so that they may 
have a perfectly firm grip, without slipping. 

From the foregoing quotations and on examining the annexed figures, it 
very clearly appears that the extraction of teeth was performed by Abul- 
casis with excessive timidity and in a manner which must have been 
torturing to the poor patients. These had to undergo, first of all, the 
detachment of the gums, then the prolonged shaking of the tooth either 
with the fingers or with the forceps, then the attempt at extraction by 
means of a stronger pair of forceps, but, so far as can be seen from the 
figure, very little fitted for the purpose; and finally, in many cases, fresh 
maneuverings to extract the tooth with an elevator. 

Fig. 39 


Fig. 40 

' ^VaVa<^.vVa^p:;wV>^ 

Forceps for performing the extraction after the tooth has been loosened (Abulcasis). 

Nothing better, in truth, could have been done with such imperfect 
instruments. But it is possible that even then there perhaps existed, 
for the extraction of teeth, other instruments, so shaped as to be able 
to act with greater force. Abulcasis himselP alludes to the existence 
of dental instruments not mentioned by him. It is probable, therefore, 
that the barbers, in spite of the scorn with which Abulcasis overwhelms 
them, used, for the extraction of teeth, forceps far more suitable than 
those described by him. These individuals, certainly unfurnished with 
a scientific education, must have had, however, a great practice in the 
extraction of teeth, being perhaps almost the only ones to whom recourse 
was had for this operation. They performed it very quickly, as may be 
argued from the words of Abulcasis himself. It is no wonder, therefore, 
that not unfrcquer^'" • fatui tonsores* was the cause 

• 1J^ ■ Silly barbm. 



of more or less serious injuries, but for the most part it had the advantage 
of not making the patients suffer excessive torture. 

Another very interesting chapter is that which treats of the extraction 
of dental roots and fragments of the maxillary bone.* 

Fig. 41 

vV tLA f \ (\ A A 

Fig. 42 

Forceps for extracting the root when the tooth breaks in the extraction. These figures are 
evidently very badly drawn, as are most of the figures to be seen in Abulcasis' work. 

When, says the author, on extracting a tooth, this breaks, so that the 
root remains in the socket, it is necessary first of all to soften the part, 
by applying for a day and a night, or for two days, some cotton wool 
well smeared with butter; then attempts must be made to extract the root 
with a pair of forceps, the jaws of which are like the beak of a pheasant 
or stork. 

Fig. 43 

Elevator to be used when the extraction of a root by means of the root forceps 

proves impossible (Abulcasis). 

If this is not successful, it is necessary to remove with a scalpel the whole 
of the gum which covers the root; then under it must be insinuated a 
small elevator having the shape here below represented. 

If not even in this way can the end be attained, recourse must be made 

* Lib. ii, cap. xxxi, p. 187. 



to one of the following instruments, choosing that which in even' par- 
ticular case seems to be the most suitable. 

Besides these, savs the author, use mav be also made of some of the 
instruments which ser\'e for the removal of tartar. 

It is precisely in this chapter that Abulcasis speaks of the great variety 
and multiplicity of dental instruments; which, he says, cannot, like other 
kinds of instruments, be all enumerated and described. He then adds 
that a skilful surgeon will be able to devise new instruments, according 
as the peculiarities of each single case require them. 

Fig. 44 

Figs. 45, 46, 47 



Fig. 48 

Elevators (Abulcasis.) 

For the extraction of a splinter or necrosed fragment of the maxillary 
bone, the same instruments must be used which serve for the extraction of 
dental roots; but also a pair of forceps may be used (Figs. 50 and 51). 

It will be necessary to grip with them the osseous fragment firmly, 
so that it cannot escape whilst it is being extracted. The part shall then 
be medicated with fitting remedies. 

Whenever it is thought proper, the bone must be scraped and all the 
diseased part of it removed. 

When a tooth is irregularly placed, or projects above the level of the 
others,* a deformity ensues which is particularly displeasing in women. 
The way of correcting this varies according to the nature of the case. 

« Lib. " 



It consists sometimes in the simple extraction of the misplaced tooth. 
But when there exists an intimate (osseous) union of the irregular tooth 
with another one, it is necessary to operate for the resection of the former 
with an instrument of the following shape, that is, like a small axe: 

Fig. 49 


An instrument like a small axe, for reseaing irregularly situated teeth (Abulcasis). 

The operation must be performed in many days, not only on account 
of the hardness of the tooth, but also in order not to shake any of the 
neighboring teeth. 

In other cases, the deformity, consisting in one tooth projecting above 
the level of the others, may be corrected with a saw. 

The instrument must be made entirely of Indian iron, and the opera- 
tion, like the preceding one, is to be carried out in several days, that 
the fall of the tooth may not be provoked by excessive shaking. The file 
(Fig. 55), too, must be used to destroy the edges and points of broken teeth, 
that they may not injure the tongue, or give any trouble in speaking. 

Fig. 50 

Fig. 51 

Forceps for extraaion of splinter or necrosed fragments of the maxillary bones (Abulcasis). 

When, in consequence of a blow or fall, one or more teeth have become 
loose so that the patient cannot bi e his food with them, if the use of 
styptic remedies has been found of no use, it will be necessary to bind 
and make such teeth firm by a gold or silver wire. Gold is to be pre- 
ferred as being unalterable, whilst silver in a few days turns green. Having 
chosen, therefore, a suitable gold wire of perfectly uniform consistency, 
it must be passed at its middle part between two firm teeth, that is between 
the two nearest on one side to the loosened tooth or teeth; then, by binding 
tightly around the sound tooth and each of the loosened teeth the two 



lengths of the wire and crossing them in the dental interstices so as to 
form a kind of network, the sound and iirm tooth of the opposite side 
will be reached, and this too must be wound around in a mesh, as it were, 
of the said network. Then, turning back, the same operation must be 
repeated, but inversely, until the point of departure is reached. All 
this must be done with much skill, so as to render the loose teeth com- 
pletely unmovable. When the wire is tied, this must be done near the 
dental roots, so that the knot may not get untied; then with a pair of 

Fig. 52 


A dental saw (Abulcasis). 
Fig. 53 


Another dental saw (Abulcasis). 

scissors the remaining part must be cut off and its two ends joined and 
twisted with a pair of pincers, hiding them between the sound tooth and 
the neighboring loose one. Such a ligature should remain in place 
during a whole lifetime; and in case it should come undone or the wire 
should break, it will be necessary to renew the operation. The following 
figure represents the ligature described: 

Fig. 54 

Ligation for steadying teeth in cases of blow or fall (Abulcasis). 

"Sometimes, when one or two teeth have fallen out, they are replaced 
in the sockets and bound in the .aforesaid manner and remain there. 
The operation must be carried out with great delicacy and ability, by 
skilful hands." 

As may be seen from the 


replanting was already performed, although it is probable that the ligature 
was then left permanently. 

The author says, next, that the vacancy left by fallen teeth can be filled 
up with artificial ones, made of ox bone, they also being fixed in the manner 
above described; and he adds that they will be found not only of advantage 
from the esthetic but also from the functional point of view. 

Speaking of the cure of the ranula,^ Abulcasis says that when the tumor, 
examined by the clear light of the sun, appears brown or black, hard and 
insensible, it is not to be operated, it being then of a cancerous nature. 
If, instead, it is whitish and full of liquid, it must be seized with a hook, 
and by means of a fine scalpel extirpated. The hemorrhage must be 
combated with powdered blue vitriol. After the operation mouth washes 
must be used of vinegar and salt. 

In cases of fracture of the lower jaw^ it is not only necessary to cure 
the fracture itself according to the rules which the author prescribes 
for the various cases, but it is also necessary to pay attention to the teeth 
and with a gold or silver wire, or a silk thread, to tie, in the manner 
already described, those teeth which in consequence of the wound have 
become loose, but the consolidation of which may be hoped for. 

Fig. 55 

:v/ ""/ J C ^ 

A dental file (Abulcasis). 

Mesue the Younger, a disciple of Avicenna, is of opinion that 
when a tooth is the seat of violent pain, this may easily propagate itself 
to the other teeth; and therefore advises, if the pain does not soon cease, 
to extract the tooth affected, without delay. This operation, however, 
must not be performed, says the author, whilst the pain is at its height, 
but rather when it is somewhat lessened, otherwise, the extraction of the 
tooth may result in a syncope sometimes ending in death, or else be the 
cause of intense inflammation and of suppuration, which, also, may, in 
certain cases, place the patient's life in danger. He recommends an in- 
finite number of remedies against odontalgia; in these, however, there is 
nothing new to us. As to the removal of a tooth, this may be obtained 
in three different ways, that is, with the forceps, with eradicating remedies, 
or by cauterization. In order to cause a tooth to fall out by the use of 
acrid, eradicating substances, the author advises to proceed in the fol- 
lowing manner: The tooth is first freed, by means of a scalpel, from the 
surrounding gum; the eradicating remedy is next applied to the root of 

• Lib. ii, cap. xxxv, p. 197. ' Lib. iii, cap. iv, p. 545. 


the tooth, every needful precaution, however, being taken that it may not 
injure the neighboring teeth. Cauterization, when practised to produce 
the exfoliation of a diseased tooth, may be performed, according to 
Mesue, either with a small red-hot iron, passed through a little metal tube 
in order to protect the neighboring parts, or with the heated kernel of a 
nut, or with a grain of burning incense/ 

To cure a dental fistula, Mesue cauterized it to the very bottom with 
a cautery in the form of a probe, or extracted the tooth, which by reason 
of its diseased root was the cause of the fistula; and when the bone 
was likewise affected, he laid bare the carious part, which he then 

* [In connection with the praaice of applying medicines to the teeth or upon the gums, 
with the object of rendering the operation of tooth extraaion less difficult, the use of 
arsenical compounds as an ingredient of these topical applications is of peculiar interest. 
In an Italian translation of the writings of Johannes Mesue, published at Venice in 1 52 1, 
the following interesting reference to the use of arsenic appears: 

''The son of Zachariah Arazi compounds a medicine to assist the extraction of the 
teeth. I^ — Pyrethrum, colquintida root and the bark of the mulberry root, the seed and 
leaves of almezeron, huruc, and yellow arsenic, milk of alscebram or pieces of it, ground 
very thoroughly with vinegar; then pour some of it over bdellium and halasce, of each, 
equal parts, dry and dissolve in strong vinegar and make trochisi of it, and with them 
anoint the roots of the tooth from hour to hour; this facilitates the extraction of it. 

''There is also another medicine with which one fills the decayed tooth and breaks it: 
I^ — Seeds of almezereon and milk of alscebram compounded with liquid pitch, and fill 
with it the decayed tooth. Another one: I^ — Bauras, bark of the willow, of each, one 
part; yellow arsenic, two parts; compound with honey and plue it upon and around the 
tooth and immediately extract it. 

"The fat of the green frog which lives upon the trees breaks teeth which are anointed 
with it the same as when you anoint them with milk of alscebram or titimallo, and similarly 
also the milk of celso with yellow arsenic." 

In this conneaion it is also interesting to note that the ancient Arabian medical writers 
referred to the red sulphide of arsenic or realgar as sandarach. The term Sandarach was 
clearly used by these writers to designate two different medicaments — one the gum-vemix, 
exudate of the Juniper tree, and which we now know as Sandarach gum. They also apply 
the term to red arsenic, as above stated. Avicenna clearly distinguishes between the two 
kinds of Sandarach, and says with regard to the gum-vemix or Juniper Sandarach that it 
is the best of all known remedies for toothache. While, as shown by Dr. Guerini, many 
of the medicaments used as topical applications to facilitate the extraction of teeth were 
wholly without any possible effect of that character, it cannot be doubted that the applica- 
tion of arsenical preparations, such as those referred to by Mesue, could not fail to set up 
an arsenical necrosis about the roots of the tooth, rendering it loose and easy of removal, 
but necessarily with the disadvantage of producing a dangerously extensive necrosis of the 

Mesue Vulgar, — Impress© in Venitia per Cesaro Arrivabeno Venitiano a di vinti octubrio, 
mille cinquecento e vintiuno. 

Delle Medicini Particulare, Libro Quarto, Capitolo XLI. — E. C. K.] 

' Joannis Mesue opera, Venetiis, 1562. 


AvENZOAR. The last of the great Arabian physicians was Aven/oar. 
He was born at Penaflor, near Seville, in 1070 and died in 1162. He 
became famous by his very valuable work on medicine, entitled the 
Teisir. It is strange, however, that in this book there is hardly anything 
about the treatment of dental diseases. Against caries and looseness 
of the teeth the author limits himself to recommending blcmdletting 
either from the ranine or the basilic vein. Apart from this, he speaks 
neither of operations nor of remedies for diseases of the teeth.' Probably 
at the time in which Avenzoar wrote, that is, in the first half of the twelfth 
centur)', doctors in general did not occupy themselves with the curing 
of teeth at all, this being abandoned entirely to barbers and other 
persons. This would sufficiently explain why this author is s^i silent 
in regard to dental diseases. 

But what can have been the reason for doctors refusing thus contemptu- 
ously to occupy themselves with so important a branch of therapeutics J 
In every age there have been a great number of ignorant pers^>ns, who 
either in good faith, or else for imposture, have practised, within a more 
or less limited circle, the art of healing, usually dedicating themselves 
to some particular class of diseases. Even in our days, notwithstanding 
the superabundance of duly qualified doctors, there is, especially in 
certain countries, no small number of quacks, secretists, bone-setters, 
chiropodists, and the like. It is, therefore, not to be wondered at that 
in times when dentistr>' was still in its infancy there should have becm 
persons more or less ignorant who undenook uxnh drawing and the 
concoction and sale of specifics against odontalgia. The drxrtors, on their 
part, under the pretext of being unwilling to have anything to do with 
these indi\iduals, found it very convenient to dispense with the cure of 
dental diseases and with the extraction of teeth, this operati^in being 
sometimes too difficult for them, on account of their want of practice, 
besides being almost always vtry painful, and considered, ev<m from the 
most ancient times, capable of eventually producing evil c^^nMrquences, 
among which, in some cases, even the death of the patient. 

But perhaps this was not the only reason for the fact aix^ve mtntumtd. 
In the middle ages the extraction of one or more teeth was u^tnt itnt% 
inflicted as a punishment; for example, for having eaten flevh during I^ent^' 
or on those found guilty of felony, for having refused to contribute usm% 
of money demanded from them by their liege lord. NV/w. as thii puniih- 
ment was carried out on the guilty ones by the crxecutoti fA publn 
justice, it is only natural that doctors sKould have refused to pr^tise an 
operatirjn miiich would have degraded their profession b} brinpnz it 
dawn nearly to the cUss ^>f the hangman. 



Bruno of Longobucco. After the Arabian period, the first author 
whom we must mention is Bruno of Longobucco, of the school of Bologna, 
who lived in the thirteenth century and wrote a treatise on surgery, 
which gave him a certain renown.* This book, however, contains but 
little about diseases of the teeth. The author shows himself a great friend 
of the actual cautery, and advises its use in the cure of dental caries and 
of various diseases of the gums. He says nothing about the extraction of 
teeth; instead, he recommends, as a means for making a diseased tooth 
fall out, that the milky juice of the tithymal be applied around its root 
after having been reduced to the consistency of paste by the addition 
of flour.' 

Lanfranchi, of Milan, another writer of the thirteenth century, who 
acquired great fame by his book Chirurgia magna et parva — partially 
translated into German, more than two centuries later, by Otto Brunfels — 
also shows himself very timid in the sphere of dentistry, and to combat 
dental pains he recommends, by preference, the use of narcotics. He 
is not at all favorable to the extraction of teeth; and especially that of 
the molars is considered by him a very dangerous operation.' 

Teodorico Borgognoni (1205 to 1298), known also under the name 
of Teodorico of Cervia, is according to Haesar the first author who made 
mention of sialorrhea following mercurial frictions. Worthy of note, 
too, is what he says in regard to fistulas of the gums, or, in general, 
of the maxillary region. He advises that in every case of this kind 
special attention be paid to the state of the dental roots; when there is 
a discharge of ichorous pus, the roots are certainly aflPected; and then the 
diseased teeth must all be extracted as soon as possible.* 

John Gaddesden, an English doctor who flourished at Oxford in 
the first half of the fourteenth century, wrote a very curious medical book, 
taken the greater part from Pliny and the Arabian writers and entitled 
Rosa angltca: practica meJictnce a captte ad pedes (English rose: the practice 
of medicine from head to foot). In his time many strange methods of 
cure were in use, sometimes simply ridiculous, and others even filthy; 

* Bruni Chirurgia magna. ^ Sprengel, Geschichte der Chirurgie, Part II, p. 280. 

' Sprengel, loc. cit. * Sprengel, loc. cit. 


and the Rosa anglica furnishes us with not few examples. In order 
to make a tooth fall, Gaddesden advises the application of dried crow's 
dung reduced to powder, or else to annoint it with the fat of a green frog. 
This last means would be quite infallible and would make the tooth fall 
out on the spot. It had such power that if peradventure an ox in grazing 
chews a little frog with the grass, its teeth will all fall out on the instant ! 
We do not know whether the author himself believed in the marvellous 
virtues of the fat of green frogs. It is certain, however, that he enumerates 
this among his "secrets," and says that he has gained much money from 
it through the mediation of the barbers. 

Other absurdities of the same kind are the following: The brain of 
the hare can, by being rubbed on the gums and jaws, serve for two im- 
portant purposes, since it has not only the virtue of facilitating dentition, 
but also of making teeth grow again to those who have lost them! The 
brain of a partridge applied to a carious tooth makes it fall in pieces! 

The treatment of odontalgia embraces, according to Gaddesden, both 
general and special means of cure. To the former belong purgatives, 
bloodletting, scarifications of the labial and sublingual mucous mem- 
brane, leeches, the application of scarified cuppings under the chin. 
The special means of cure are represented by a great number of plasters, 
powders, and ointments, in the composition of which almost constantly 
hyoscyamus and pyrethrum take part. When odontalgia depends on 
caries, the author advises, among other things, the use of a red-hot iron. 
Against the supposed worms of carious teeth he counsels fumigations 
with the burnt seeds of hyoscyamus or of leeks. In cases of dental 
fistulas, it is necessary to cauterize the fistulous tract, to extract the 
diseased tooth, and if the bone be also affected, to scrape it. To clean 
the teeth: Gaddesden recommends several dentifrices; some of which 
are composed of pulverized cuttle bone, either with addition of meer- 
schaum, pumice stone, burnt hartshorn, in different proportions and com- 
binations, or used quite alone; others are made with myrrh and alum. 

Since Gaddesden affirms the existence of means capable of promoting 
the fall of any tooth, we should suppose that he says nothing about instru- 
mental extraction, or at least that he considers it entirely useless; for if 
in order to make a tooth fall out, it be sufficient to smear it with frog's 
fat, why should there ever be any need to have recourse to the very 
painful extraction by means of the forceps ? 

However, this is not so; the author treats of instrumental extraction as 
a very important operation, without being at all afraid of being reproved 
for contradicting himself. Besides, to anyone who thus reproved him 
he perhaps would have answered, without being disconcerted, that it 
is not always possible to have the fat of frogs or the dung of crows in 


The extraction of a tooth is only justifiable, says Gaddesden, when all 
the remedies employed against odontalgia have proved useless and when, 
on the other hand, the pain has its seat in the tooth itself and not in the 
nerves or gums. Before undertaking the operation, however, the patient 
must be prepared for it with an evacuant cure, that is, by injections and 
purgatives. For the operation itself the author recommends the same 
rules given by Celsus, and says, besides, that the head of the patient 
ought to be held firm by an assistant. In certain cases, the extraction 
can be performed, better than with the forceps, by means of an instru- 
ment in the form of a lever, broad at one end, narrow and sharpened 
at the other. But when a tooth is very firmly seated, its extraction is 
always dangerous; therefore, in such a case, Gaddesden recommends, 
before having recourse to the operation, the use either of acrid sub- 
stances, such as the milky juice of the euphorbiaceae (for example, of the 
tithymal), or else of a red-hot iron; and this, for the purpose of promoting 
the fall of the tooth, or of rendering it, at least, so far movable that 
it can be extracted without any difficulty. 

Guy de Chauliac, the greatest surgeon of the middle ages, was born 
about 13CX), in a little village on the confines of Auvergne, which still 
preserves the name of Chaulhac; he died in 1368. This author immor- 
talized his name by a work which even up to the eighteenth century 
was, as it were, the official code for the teaching of surgery. Guy wrote 
his Chirurgia magna in barbarous Latin — such as was then used by the 
learned; but his book was soon translated into French, Provencal, and 
afterward also into Italian, English, Dutch, and Hebrew. E. Nicaise, 
who, in 1890, gave to the scientific world a very valuable new edition of 
Guy de Chauliac,* and who made very accura e researches on all that 
regards this author and his work, has succeeded in finding in the libraries 
of Europe and America as many as thirty-four manuscript copies of 
the High Surger} The survival of so many copies, in spite of all the 
destructive agencies which have been in action during more than 500 
years, is a very clear proof of the wide diffusion which this work obtained 
even before the invention of printing. 

Guy's work was printed for the first time in 1478, and the editions that 
have been published since then in various countries are in all about 130. 

This book is very important for our subject, since we may gather from 
it very clearly the condition of dentistry in the fourteenth century; but, 
on the other hand, we see from it, with equal clearness, that this branch 

' La Grande Chirurgie de Guy de Chauliac, chirurgien maistre en medecine de TUni- 
versite de Montpellier, composee en I'an 1363, revue et collationnee sur les manuscrits et 
imprimes latins et fran^ais par £. Nicaise, 1890. 

^ Of these copies, twenty-two are written in Laftn. four in Frendi, two in Provencal, three 
in English, one in Netherlandish ^ **. 


of the healing art had not made any progress from the time of Abulcasis 
to that of Guy de Chauliac (about two centuries and one-half), and that 
this most famous surgeon did not contribute anything worthy of note 
to the development of dentistry. 

On the anatomy and physiology of the teeth Guy de Chauliac ex- 
presses himself very briefly: "Teeth are of the nature of bones, although 
they are possessed of sensibility, due to some nerves which the third pair 
sends to their roots. The number of these latter may vary from one to 
four, according to the diflPerent teeth. The uses of these organs are well 

Worthy of being recorded are the names which Guy gives to the dif- 
ferent kinds of teeth. After having said that these latter are generally 
thirty-two, but sometimes only twenty-eight, he adds, that the sixteen 
teeth of each jaw are divided into: deux duellesy deux quadruples ^ deux 
canitiesy huiet maschelieres^ et deux caisseaux (in the barbarous Latin: 
duo dualeSy duo quadruplty duo cantnty octo molar es et duo cay sales). So 
that the two middle incisors were then called duales; the lateral incisors 
were called quadrupliy because, together with the middle ones, they formed 
a series of four teeth. Guy gives the name of caysales (caisseaux) to the 
last two molars; but Joubert, one of the translators and commentators 
of Guy de Chauliac, tells us that the molars in general were called in 
Languedoc caisseaux: "Les cinq molaires sont appelees en Languedoc 
caisseauxy parce qu'elles servent a casser les choses dures, comme les 
noix et semblables." In regard to the canines of the upper jaw, we 
learn that they were called oeilleres (eye teeth), because their root was 
believed to reach near the eye.' 

According to Guy de Chauliac, les dents sont engendrees non seulement 
en Venfancey ains aux autres ages.* And this passage was commented by 
Joubert in the following note, which we reproduce textually: 

"En Languedoc, pres de Pezenas y a unc gentil fenime, nomme 
Mademoiselle de Lobatiere, des long temps vieille edentee, a laquelle 
(comme tesmoignent beaucoup de gens tres-dignes de foy) environ Tan 
70 de son age, sont sorties cinq ou six dents nouvelles. Le conciliateur 
tesmoigne avoir veu, a qui les dents perdues devant Tan 60 ont ete derechef 
engendrees, moindre toutes fois que les premieres et plus foibles."* (In 
Languedoc, near Pezenas, there is a lady named Mademoiselle de Loba- 
tiere, who having been for a long time old and toothless (according to 

* Nicaise, La Grande Chirurgie de Ciuy de Chauliac, Second Chapitre: De TAnatoniie 
de la face et de ses parties, p. 47. 

' Here, as elsewhere, is preserved the old orthography of the text. 
'Nicaise, p. 711. 

* Teeth may be produced not only in infancy, but also at a later age. 

* Nicaise, p. 205. 


the testimony of persons well worthy of belief), at about the age of seventy 
got five or six new teeth. The Conciliator* testifies to having seen teeth 
grow anew — smaller, however, and weaker than the first — in persons who 
had lost them before the age of sixty years). 

In regard to the pathology and therapy of the teeth, Guy but rarely 
abandons the footsteps of the Arabian writers. Following the example 
of one of these, Ali Abbas, he admits five or six dental maladies: pain, 
corrosion, congelation, and agacement (teeth set on edge), limosity or 
fetidness, fall or loosening.' As to the cure, this is divided into universal 
and particular. The former includes, before all, hygienic rules, and 
then purgatives, bloodletting of the cephalic vein or the veins of the 
lips or tongue, revulsion, obtained by means of cupping glasses, friction, 
etc., and the remedies for curing the rheums of the head, or for throwing 
out the phlegmatic humors (pyrethrum, mastic, and the like). 

The hygienic rules are the following: Not to eat food apt to putrefy, 
such as fish and milk foods; to avoid food or drink either too hot or too 
cold, and especially the rapid succession of cold and hot, or vice versa; 
not to bite hard things, nor to eat viscous food, such as figs and confec- 
tionery made with honey; to avoid certain foods which are known to be 
bad for the teeth, such as leeks; not to clean the teeth too roughly, but 
to rub them with honey and burnt salt, to which, very advantageously, 
may be added some vinegar. 

Before speaking of the special methods of cure of single dental affec- 
tions, Guy observes that operations on the teeth are particular (proper) 
to barbers and to " dentatores,"' to whom doctors have abandoned 
them. But it is safest of all, says he, to have such operations performed 
under the direction of doctors. These, however, to be in a position to 
give advice in regard to diseases of the teeth, must know the various 
methods of cure which are suited to these diseases, that is to say, mouth 
washes, gargles, masticatories, fillings, evaporations, anointments, rubbings, 
fumigations, cauterizations, sternutatories, instillations into the ears, and 
manual operations. 

Lastly, Guy notes that the '' Jeniator** must be provided with all the 
appropriate instruments, that is, with "rasoirs, rapes, spatumes, droits 
et courbes, eslevatoires simples et a deux branches, tenailles dentelees, 
et diverses esprouvettes, cannules, deschaussoirs, tarieres, aussi des 
limes, et plusieurs autres necessaires a cette besogne" (in Latin: rasoriis, 
raspatoriis, et spatuminibus rectis et curvis, et levatoriis simplicibus 

' Pietro of Albano (1250 to 13 16), the writer of many books, among which one bearing 
the title of Conciliator diflPerentiorum philosophorum et praecipue medicorum, is often quoted 
by Guy de Chauliac and by many others under the name of Conciliator. 

^ Nicaise, p. 505. ' Appropriatae barbitonsoribus et dentatoribus. 

* In one Latin manuscript of 146 1 instead ofJettiaior we »l»^'*« <qd the word dtntistm. 


et cum duobus ramis^ tenaculis dentatis^ et probis diversis, cannulis, 
scalpis et terebellis, et etiam limis."* 

Whilst Abulcasis bitterly declaims against the barbers, because they, 
in spite of their ignorance, permit themselves to perform operations on 
the teeth, and especially to extract them, Guy de Chauliac speaks in quite 
a different tone. He recognizes that such operations are particular^ 
which is as much as to say, in modern language, that the practice of dental 
surgery constitutes a specialty. Guy, it is true, expresses his desire that 
dental operations be performed, for greater security, under the direction 
of doctors, but he does not use one word of blame or contempt against the 
dentatoresy thus leaving it to be understood that, according to him, their 
art had every good reason to exist. Besides, from the enumeration of 
the surgical instruments which Guy says are necessary to them, we can 
easily argue that the dentatores of the fourteenth century were not, as 
at the very first one might be led to believe, mere "tooth-pullers," but 
that, at least, the best among them cured teeth as well as the scanty 
knowledge and means of cure then available enabled them to do. 

In the chapter on odontalgia,^ Guy de Chauliac distinguishes between 
the pains, the point of departure of which is in the tooth itself, and those 
resulting from disease in other parts, for example, from apostema' of 
the gums; in these latter cases, in order to cause the pain to cease, it is 
necessary to cure the part from which the pain is derived, taking into 
account the nature of the disease and its causes. 

When the pain is situated in the root of the tooth or in its nerve, it 
is necessary, says the author, to distinguish whether it is caused by an 
accumulation of morbid matter, or whether it is, instead, a simple pain 
without matter. Besides, it is necessary to distinguish, in the first case, 

* Nicaise, p. 506. To make clear the meaning of these names, the following must be 
noted: The rasoirs {rasoria) were instruments with one cutting edge alone, which were 
used in performing any kind of incision. Raspatoria (rapes, i. e., rasps) signified almost 
certainly scrapers, not rasps. The spatumes were instruments with one or two cutting edges, 
of various shapes, but usually small. Esprouvettes (Latin, proba) were the sounds or probes. 
Scalpra means scalpels, but in this case has especially the meaning of dechaussoirSy gum 
lancets. Terebelli (French, Tarieres) are the trepans or perforators. 

' Nicaise, p. 507. 

' By the word apostemoy Guy de Chauliac, and many other writers, indicate every patho- 
logical condition in which the normal elements of the tissues are separated from one another, 
by a humorous or gaseous gathering, or by any phlogistic or neoplastic formation. The 
word signifies, in Greek, removal, just like the Latin word abscessus. In fact, these two 
terms were often used as synonyms; but at other times the word apostema had a wider 
meaning, and included, besides the abscess, the phlegmon, the furunculus, the anthrax, ery- 
sipelas, herpes, and other dermal affections, especially the pustulous ones, edema and other 
serous gatherings, subcutaneous emphysema and other gaseous gatherings, glandular 
tumefactions, cysts, benignant and malignant tumors, 


whether the matter producing the pain is hot, cold, or windy; and also, 
in the second case, it is necessary to ascertain if the pain is of a warm, 
cold, dry, or humid nature. ' As may be seen, the principles and subtle 
distinctions of the pneumatic school were then in full vigor. 

The treatment must vary according to all the aforesaid cases; but 
the means of cure advised by Guy de Chauliac do not present any 
special interest, as they are almost entirely taken from Galen and 
from the Arabian authors, and especially from Rhazes, Ali Abbas, and 

On coming to speak of the looseness of teeth, ^ Guy says that this may 
depend on various causes: that is, on a fall or a blow; on humidity, 
which softens the nerve and ligament;^ on dryness and lack of nourish- 
ment of the teeth; and lastly, on corrosion of the gums. 

The looseness of teeth, which depends on dryness or want of nutrition, 
as in the old and in consumptive people, is incurable. In other kinds 
of looseness, astringents are useful; but it is also well that the patient 
should speak but little, that he should not touch or move the loose tooth, 
nor use it in masticating. In cases of corrosion of the gums, this disease 
must be cured. 

If looseness of the teeth follows a blow, it is well, first of all, to let blood, 
and then to use astringents and excitants. When all this is of no avail, 
Guy advises that the loose teeth be tied to the healthy ones with a little 
gold chain,' after the manner of Abulcasis. And if, says he, the teeth fall 
out, they may be replaced with teeth of another person, or with artificial 
teeth of ox bone, fixing them in their place with a fine ligature; and, 
he adds, that such teeth are serviceable for a long time. Here are the 
precise words of the text: "Et si les dents tombent, qu'on y mette des 
dents d'un autre, ou qu'on en forge d'os de vache, et soient lisez finement, 
et on s'en sert long-temps." 

This extremely concise manner of treating dental prosthesis, summing 
all up in some thirty words, is in strong contrast with the usual fulness 
of explanation and methodical accuracy of Guy de Chauliac, to whom, 
very justly, could be given the title of founder of didactical surgery. Such 
a strange contrast cannot be explained, unless by admitting that Guy 
considered dental prosthesis as foreign to the general plan of his book, 
that is, as something which did not directly concern surgeons, and for 
which, therefore, a mere allusion ought to be suflicient. Without the 

* De la dent esbranlee et aflPoiblie, Nicaise, p. 509. 

* '*De rhumidite qui amollist le nerf et le ligament." 

^ Evidently the author speaks of a "little gold chain/' because, as he is not versed in the 
practice of dentistry, he does not know that it was a simple gold wire which was used for 
keeping loose teeth Arm. A small chain as thin at a thee*'* '^■U mm^ be possibly made, 
and would even then be excessively wea^ 


slightest doubt, dental prosthesis was practised neither by doctors nor 
surgeons, but by the dentatores, 

Abulcasis, too, certainly for the same reason, is extremely brief in 
speaking of artificial teeth, but, on the other hand, he very minutely 
describes the process of ligating loose teeth. Guy omits this description 
entirely, and only alludes briefly to this therapeutic practice. From 
this it is easy to perceive that whilst Abulcasis considered this operation 
within the province of surgeons, Guy de Chauliac was disposed to exclude 
it from the field of general surgery, considering that this, too, like the 
other dental operations, belonged to the dentatores. In his days, in short, 
dentistry had become much more clearly specialized than it was in the 
days of Abulcasis. 

After having spoken of the looseness of teeth, Guy de Chauliac goes 
on to treat of caries, in a short chapter, entitled "De la Pourriture, des 
vers, de corrosion et pertuifement des dents." 

The method of cure, he says, is double, viz., universal and particular. 
The general treatment embraces the hygienic and therapeutic means 
already mentioned. As to the particular or local treatment, it consists, 
first of all, in washing the teeth with aqua vitae or with a vinous decoction 
of mint, salvia, melissa, pepper, or pyrethrum. Then it is necessary to 
fill the carious cavity with gallia* and root of cyperus,' mastich, myrrh, 
sulphur, and camphor, wax, ammoniacum, asafetida and the like. As 
may be seen, Guy does no more than mention the substances used in 
his days for the filling of carious teeth, and does not tell us what various 
combinations were formed with the said materials, nor the proportions 
in which they were used. In short, he does not give us any formula for 
the composition of a filling mass, and from this may be inferred, without 
fear of error, that this operation also was never performed by him, 
consequently it, too, was not practised by doctors and surgeons, but 
rather by the dentatores. 

When the aforesaid means of cure — that is, the mouth washes and the 
filling — are of no use, Guy advises the margins of the carious cavity being 
taken away with a scalpel and file, so that alimentary substances may 
not be retained inside it. However, here are his words, which seem 
especially to refer to cases of interstitial caries: 

" Si ces choses n'y valent rien, la dent soit esbuschaillee avec un ciseau 
et lime,' e qu'on luy fasse un passage, a ce que la viande ne s'arreste 

* This name was first given to medicaments containing gall-nuts, then, by extension, also 
to compound remedies not containing such substance, and to which was given the name 
of alipta^ V. Nicaise, p. 677. 

'According to Nicaise, the Cyperus esculentus (in French, "souchet") is here referred to. 

' In the Latin text: Buccelletur cum scalpro et lima. 


au trou." If advantage is not even derived from such an operation, 
recourse must be had to cauterization, or, if necessary, to extraction. 

Even Guy de Chauliac believes in the worms of the teeth, and against 
these he recommends the usual fumigations. He advises that the seeds 
of leek, onion, and hyoscyamus be mixed with goat's tallow and made 
into pills of a dram each in weight, one of which is to be used for 
each fumigation: "Si dans le trou il y a un ver, apres le susdit 
lavement,* la dent soit suffumiguee avec une graine de porreau et d'oignon 
et semence d'hyosciame, confits avec suif de bouc; et qu'on en fasse 
des pilules chacune d'une drachme et qu'on y en employe une a chaque 

In the following chapter Guy treats "De la limosite et laide couleur des 
dents." Here, too, he recommends, before all, the general hygienic rules 
above mentioned. Besides, he advises the mouth being rinsed with a 
vinous decoction of wild mint and of pepper, and then the use of the 
following dentifrice: 

"I^ — Cuttle-honey small white seashellsy pumice stoney burnt stags horny 
nttrey alumy rock salty burnt roots of irisy aristolochiay and reeds. All 
these substances must be reduced to powder together, or each one sepa- 
rately." Use may also be made of a liquid dentifrice thus prepared: 

"I^ — Sal ammoniac and rock salty half a pound of each; saccharine alumy 
one-quarter of a pound. These to be reduced to a powder and placed in 
an alembic of glass, so as to obtain a liquid, with which the teeth must 
be rubbed by means of a little scarlet cloth." 

If these means of cure are of no avail, on account of the presence of 
hardened limosity (tartar), this must be removed by scraping it away 
with appropriate instruments. "Et si cela ne profite, a cause qu'il y a 
la des limosites endurcies; soient rasclees avec des rapes et spatumes."' 

Against the setting of teeth on edge {endormement et congelation des 
dents; stupor et congelatio dentium)y Guy de Chauliac recommends hot 
wine or aqua vitae, to be kept in the mouth; or the teeth to be rubbed 
with roasted salt; or the application to them of hot roasted walnuts and 
filberts and similar things which convey heat; or lastly, masticating sub- 
stances, which possess heating properties, such as the portulaca (purslane) 
and its seeds. 

The chapter on the extraction of teeth and of dental roots is a simple 
summary of what Abulcasis says on this subject; some passages of this 
author are copied word for word. 

Whilst the Arabian surgeon treats rather lengthily of the deformities 
of the dental arches, and the methods to be employed in correcting these, 

* Here lavement means mouth wash, not injection. 
' Cum raspatoriis et spatuminibus radantur. 


Guy de Chauliac almost entirely neglects this subject and limits himself 
to saying that if any tooth has become abnormally lengthened, it is 
necessary to reduce it to the right length with the file, but operating 
"wisely," so as not to loosen it: 

"S'il y a quelque dent augmentee outre nature, soit egalisee et applanie 
sagement avec la lime, que ne soit ebranlee." 

Guy strongly throws doubt upon the efficacy of supposed eradicating 
remedies. In regard to this he says: "The ancients mention many 
medicaments, which draw out the teeth without iron instruments or which 
make them more easy to draw out; such as the milky juice of the tithymal 
with pyrethrum, the roots of the mulberry and caper, citrine arsenic, 
aqua fortis, the fat of forest frogs. But these remedies promise much 
and operate but little — mats Us donnent heaucoup de promessesy et peu 
d^ operations, ^^ 

From the book of Guy de Chauliac we can gather a very important 
fact, which is worth mentioning here; that is to say, that some surgeons 
of that period made use already of anesthetic inhalations, especially for 
amputations. Here is what Guy says:* 

"Some prescribe medicaments which send the patient to sleep, so that 
the incision may not be felt, such as opium, the juice of the morel,' 
hyoscyamus, mandrake, ivy, hemlock, lettuce. A new sponge is soaked 
by them in these juices and left to dry in the sun; and when they have 
need of it they put this sponge into warm water and then hold it under 
the nostrils of the patient until he goes to sleep. Then they perform 
the operation." 

It seems that the narcosis thus obtained was sufficiently intense, since 
Guy also speaks of the means used to awaken the patient. These con- 
sisted in applying another sponge, soaked in vinegar, under the nose, or 
in dropping into the nostrils and ears the juice of rue or fennel. 

Guy lets us know that other surgeons made the patients go to sleep 
by giving them opium to drink; but he decidedly disapproves of such a 
practice, as he has heard of patients who through this have died. 

Valescus of Taranta (called by the French authors Valescon or 
Balescon de Tarente or Tharare), professor at the University of Mont- 
pellier at the beginning of the fifteenth century, wrote a valuable treatise 
on medicine and surgery, entitled Philonium pharmaceuticum et chirur- 
gicuniy de medendis omnibus humani corporis affectibus. As to the dis- 
eases of the teeth, he especially follows Guy de Chauliac, but treats the 

' Treatise vi, doctrine i, chap, viii: "Des membres qu'il faut amputer/' etc., Nicaise, 

p. 435- 
' According to Joubert several solanacese had this name, among others Solanum nigrum 

and Solanum somniferum (Physalis somnifera L.), which probably corresponds to the 

Sfrychnos hypnoticus of Dioscorides. 



subject at greater length, profiting by what has been written on the 
subject by all the ancient writers, and especially the Arabians. 

Among the many remedies which he recommends against toothache, 
here are some: 

"I^ — ^Wild mint, pyrethrum, white pepper, myrrh, two drams of each; 
let these be pulverized and made into a paste with the pulp of raisins or 
with white wax and with some turpentine; and let this mass be divided 
into small balls as large as filberts, of which one must be masticated at a 
time, with the aching teeth. "^ 

Another masticatory is composed of origanum, pyrethrum, cinnamon, 
and ginger, made into a paste with the yolk of an egg cooked under the 

To calm dental pains, the vapors of a decoction of wild lavender, 
marjoram, rue, chamelea, and melilot are often efficacious. As to fumi- 
gations, they can be made not only with vegetable substances (onion or 
mustard seed, rue, etc.), but also by burning scrapings of the hoof of an 
ass. The fumes may be made to reach the aching tooth, by means of a 
funnel. Here are the words of the author: "Fiant suffitus ex rasura 
ungulae asini, et fumus recipiatur per infundibulum." 

Decayed teeth may be filled, according to Valescus, to satisfy four dif- 
ferent indications: To calm or prevent pain, to prevent any further spread- 
ing of the caries, to kill the worms, and to sweeten the breath. He advises 
that the carious cavities should be filled up with powdered nigella, pepper, 
myrrh, salt, and theriac; or else with pyrethrum, gum ammoniac, and 
opium; or else with celery seeds pulverized, opium, and hyoscyamus; 
or with the cast-off skin of serpents boiled in vinegar; or with gallia and 
cyperus. The filling with these last two substances are especially suit- 
able, according to the author, to preserve the teeth from further spreading 
of the caries: "Si gallia et cyperus cavis dentibus applicentur, dentes 
ulterius non corrodentur." 

To kill the supposed worms of the teeth, Valescus counsels three 
different methods, of which the first consists of the usual fumigations 
with seeds of hyoscyamus, onion, leek, coloquintida; the second consists 
in filling the carious cavity with a mixture of myrrh and aloes; and lastly, 
the third, in applying inside the cavity the milky juice of the tithymal, or 
the juice of the persicaria.^ 

In regard to tartar of the teeth — which he calls materia lapidea^ /. e,y 
stony substance — Valescus says that it must be removed little by little, 
either with iron instruments or with dentifrices partly cleansing and partly 

* Valesci Philonium, etc. ; Francofurti MDXCIX, cap. Ixiv, De dolore dentium, p. 195 
et seq. 

' Plant belonging to the order of the Polygonaceae. 


styptic. After the tartar has been removed, it is necessary to wash the 
teeth often with white wine and to rub them with roasted salt.^ 

Valescus, too, like the majority of ancient writers, is not at all favor- 
able to the extraction of teeth. He says that recourse must not be had 
to this operation except when a tooth is the cause of most violent pain 
and every remedy has been of no avail. But the reasons which he gives 
in support of this opinion are very plausible; and whilst most of the 
authors who preceded him showed themselves adverse to extraction, 
because they considered it dangerous, he does not allude in the least to 
such dangers, but wishes extraction to be avoided, if possible, "because 
the teeth, even when they are in some parts corroded, yet nevertheless, 
after the pain is calmed, aid mastication and besides render the others 

This author agrees with Galen in considering the teeth as bones, but 
he is of opinion that they differ from the other bones in more than one 
respect; that is, first of all, on account of their sensibility; secondly, be- 
cause, whilst the other bones are formed in the uterus, the teeth are formed 
outside the uterus; and lastly, for a reason which cannot but appear very 
strange to us, that is: "The bones are produced by the sperm and 
menstrual blood, whilst the teeth are produced by the blood in which there 
has remained the virtue of the sperm."' This passage gives us an idea 
of the state of embryological knowledge of those days! 

PiETRO OF Argelata (or of La Cerlata), professor of surgery at Bologna 
(died in 1433), wrote a treatise on surgery in six books, in which diseases 
of the teeth are also taken into serious consideration. He speaks of a 
great number of dental instruments, which, however, are the same as those 
enumerated by Guy de Chauliac. His methods of cure do not offer 
anything very new, being for the most part identical with those of Avicenna 
and Abulcasis. He considers cleanliness of the teeth of the greatest 
importance; shows what great injury is done by dental tartar — which 
by him is considered a very important sign of the bad state of the teeth 
— he counsels the removal of it by means of scrapers, files, or the use 
of strong dentifrice powders; and to make the teeth white, he even 
advises the use of aqua fortis. 

He says nothing in regard to the filling of decayed teeth; he, however, 
counsels the cleansing of the carious cavities with aqua fortis, or even, 

* ''Materia lapidea paullatim abradatur ferro et dentifriciis partim mundificativis, et 
partim stypticis. Deinde colluantur dentes sarpe vino albo, et fricentur sale torrefacto." 
Cap. Ixviiy De colore dentium pneter naturam, p. 202. 

' ''Quoniam, licet ex parte corrosi sint, attamen dolore sedato masticationem iuvant, 
et alios firmiores reddunt." Appendices, p. 205. 

' "Ossa fiunt ex spermate et sanguine menstruo; dentes autem ex sanguine, in quo 
remansit vinus spermatis." Appendices, p. 205. 


in some cases, the widening of them, in order to render them shallower 
and therefore less liable to retain alimentary residues. 

Pietro of Argelata cured dental fistulas by means of caustics and 
arsenic. He counselled simple palliative means of cure for hard epulides 
of a cancerous nature. In regard to soft, benignant epulides, he was 
little favorable to excision, as this might cause hemorrhage ; he preferred 
ligating the tumor; or he repeatedly cauterized it with boiling oil or other 
caustics, until he caused it to fall.^ 

Bartolomeo Montagnana, who taught surgery in the University of 
Padua and died in 1460, recommended, as an excellent anti-odontalgic 
remedy, a mixture of camphor and opium. In his days, faith in the 
pretended eradicating virtues of certain substances was being gradually 
lost; but, on the other hand, a tendency now arose to neglect, in regard 
to the teeth, the conservative principle, to which the ancients had held so 
jealously; and little by little the extraction of a tooth began to be considered 
an operation of small or no importance, that could be performed with the 
greatest indifference. Montagnana himself considers the extraction of a 
tooth as the best means of curing odontalgia, whilst the ancients did not 
have recourse to it, saving as a last resource. Notwithstanding this, if 
the caries was not deep, he preferred to extraction the use of caustics and 
a red-hot iron.^ 

Giovanni Plateario, a professor at Pisa in the latter half of the fif- 
teenth century, cauterized carious teeth with a small piece of kindled 
ash wood, or with a red-hot iron, and held that cauterization was more 
effectual when, before performing it, the carious hollow had been filled 
up with theriac' 

He, too, made the administration of purgatives or bloodletting precede 
the extraction of a tooth. Plateario has, however, the merit of having 
introduced the sitting position for operations on the teeth, whilst preceding 
surgeons made the patient lie in a horizontal position, or held his head 
steady between their knees, as may be read in Abulcasis and in other 
writers. Besides, he recommends taking care, when the extraction of a 
tooth had to be performed, that the surrounding air should be pure; 
perhaps because he thought that when operating in a place where the 
air was tainted, complications might more easily arise, on account of 
contagious substances reaching the inside of the wound ; or perhaps 
because he judged, not without reason, that certain accidents, such as 
syncope, could more easily happen, and were more dangerous in a tainted 
atmosphere than in the midst of pure, vivifying air. After the operation, 

* Petri de Largelata chirurgiae libri sex, Venetiis, 1480. 

' Bartolomai Montagnana Consilia, Venetiis, 1 497* 

^ Johannis Platearii Salemitani practica brevis, Lugduni, 1525. 


he prescribed astringent mouth washes. Against dental worms, whose 
existence no one at that period doubted in the least, Plateario recom- 
mended various remedies, chiefly under the form of fumigations; and 
among these latter, those performed with burnt opium. Against ulcera- 
tions of the gums and mouth he commended the use of wine and aro- 
matic substances. An excellent remedy was also, according to him, 
lime dissolved in very strong hot vinegar, and mixed, after complete 
evaporation of the liquid, with a fourth part of orpiment. 

Giovanni of Arcoli (in Latin, Joannes Arculanus)^ professor at 
Bologna and afterward at Padua (who died in 1484), wrote a commentary 
on a celebrated book of medicine, which Rhazes had dedicated to the 
glorious King Almansor, great patron of science and art.^ 

In this most valuable work of Arculanus there are several chapters 
relative to diseases of the teeth; and this subject is treated rather fully 
and with great accuracy. 

The author, first of all, treats of the anatomy and physiology of the 
teeth; he, however, falls into many errors, for instance, in regard to the 
number of dental roots. ("The first six teeth of the upper jaw have 
only one root; the first six of the lower not more than two; the molars of 
the upper jaw have three; those of the lower generally only two in like 
manner; the neguezid^ of the upper jaw have four roots, but the two 
lower neguezid have only three.") 

According to him there is not the least doubt that the teeth grow during 
the whole lifetime, thus repairing the continual waste caused by use; 
and among other proofs he adduces that, whilst in the old all other organs 
shrink and waste away through lack of nourishment, the teeth, on the 
contrary, show very frequently an increase in length. 

For the preservation of teeth — considered by him, quite rightly, a 
matter of great importance — Giovanni of Arcoli repeats the various 
counsels given on the subject by preceding writers, but he gives them 
as ten distinct canons or rules, creating in this way a kind of decalogue 
of dental hygiene. These rules are: (i) It is necessary to guard against 
the corruption of food and drink within the stomach; therefore, easily 
corruptible food — milk, salt fish, etc. — must not be partaken of, and 
after meals all excessive movement, coition, bathing, and other causes 
that impair the digestion, must also be avoided. (2) Everything must 
be avoided that may provoke vomiting. (3) Sweet and viscous food — 
such as dried figs, preserves made with honey, etc. — must not be partaken 
of. (4) Hard things must not be broken with the teeth. (5) All food, 

» Joannis Arculani commentaria in nonum librum Rasis ad regem Almansorem, etc., 
Vcnctiis, 1542. 

* This Arabian word was used to indicate the last molars. 


drink, and other substances that can set the teeth on edge must be 
avoided. (6) Food that is too hot or too cold must be avoided, aild 
especially the rapid succession of hot and cold, and vice versa. (7) 
Leeks must not be eaten, as such a food, by its own nature, is in- 
jurious to the teeth. (8) The teeth must be cleaned, at once, after 
every meal, from the particles of food left in them; and for this purpose 
must be used thin pieces of wood somewhat broad at the ends, but not 
sharp pointed or edged; and preference should be given to small cypress 
twigs, to the wood of aloes, of pine, rosemary, of juniper, and similar 
sorts of wood which are rather bitter and styptic; care must, however, 
be taken not to search too long in the dental interstices and not to injure 
the gums or shake the teeth. (9) After this, it is necessary to rinse the 
mouth, using by preference a vinous decoction of sage, or one of cinnamon, 
mastich, gallia, moschata, cubeb, juniper seeds, root of cyperus, and 
rosemary leaves. (10) The teeth must be rubbed with suitable denti- 
frices before going to bed, or else in the morning before breakfast. Al- 
though Avicenna recommended various oils for this purpose, Giovanni of 
Arcoli appears very hostile to oleaginous frictions, because he considers 
them very injurious to the stomach. He observes, besides, that whilst 
moderate frictions of brief duration are helpful to the teeth, strengthen the 
gums, prevent the formation of tartar, and sweeten the breath, too rough 
or too prolonged rubbing is, on the contrary, harmful to the teeth and 
makes them liable to many diseases. As a dentifrice, he recommends 
a mixture of two parts of honey to one of the best sugar; or the ashes 
of the burnt head of a hare; or burnt salt made into an electuary by the 
addition of honey. To use the last two dentifrices, a quantity about 
equal in volume to a filbert must be wrapped and tied inside a thin, 
loosely woven piece of linen cloth, and with this the teeth must then be 
rubbed. Finally, theriac, too, is considered by him a very good dentifrice. 
According to Arculanus, dental pains are sometimes situated in the very 
substance of the tooth, at other times in the nerve, and at others in the 

The dental substance may become painful, owing to bad ** complexion" 
(viz., constitution), without there being any morbid matter in it. When, 
however, such matter exists, it may proceed from the head or from the 
stomach, and in certain cases it gives rise to an apostema of the tooth ; 
in other cases it corrodes the latter; and at other times generates (!) in 
it a worm, which in its turn corrodes the tooth. 

In regard to the diagnosis of dental pains, it is necessary first of all to 
examine the state of the gums, that is to say, to observe whether these, 
in the aching spot, appear healthy, or whether, on the contxaryi they are 
discolored or tumid, sanguinolent, suppuradr- 
or putrefaction, or if, when pressure •" 


is produced. In such cases it may be considered that the gums are the 
seat of the pain. But if none of these symptoms are observed, and if, 
on comparing the gums of the aching spot with the other gingival regions, 
no difference is observed, this means that the cause of the pain exists 
either in the substance of the tooth itself, or else in its nerve. In this 
latter case the pain is usually very violent, and principally localized in 
the root of the tooth, but also extending along the jaw, and the tooth itself 
is often, as it were, benumbed. When, however, the pain is not situated 
either in the gums or in the dental nerve, but in the very substance of the 
tooth, this latter is very often corroded (carious), and very often in the 
hollow there exists a worm ; and this may be deduced from the fact 
that during the intervals of calm the patient sometimes feels a peculiar 
sensation, the movement of the worm in the diseased tooth; when, how- 
ever, these signs are wanting, we shall find at any rate that the whole 
tooth is painful in the direction of its length, instead of the pain being 
localized in the root of the tooth and radiating along the jaw. 

When the cause of the pain resides in the gums the extraction of the 
tooth is neither necessary nor beneficial, but is, on the contrary, always 
harmful, since, in spite of the loss of the tooth, the cessation of the pain 
is not obtained; when the pain is situated in the tooth itself, the removal 
of the latter always makes the pain cease; lastly, when the dental nerve is 
the seat of the evil, the removal of the tooth sometimes takes away the 
pain, at other times it does not. 

Among the many anti-odontalgic remedies, Arculanus enumerates 
pepper mixed with tar, pepper with asafetida, mustard seeds with asa- 
fetida, and the like. When a tooth is to be cauterized, it is necessary 
to protect the healthy teeth with bits of cloth dipped in rose water or 
else with some kind of paste. Sometimes it is useful to drill the tooth 
with a small trephine so that the cautery may act more deeply, thus 
giving better results. 

In regard to the filling of decayed teeth, Giovanni of Arcoli says that, 
in the choice of the substances to be used, the complexion (constitution) 
of the teeth must be taken into consideration ; and according as this is 
cold or warm, it is necessary to perform the filling with substances which 
are, by their own nature, warm or cold, thus acting in opposition to the 
dyscrasia of the tooth : 

" Eligantur caltda aut frigida secundum opportunitatemy in contrarium 
dyscrasia dentis.*' 

As to the quality of the complexion, this might be deduced, says the 
author, from various signs, among which the color of the gums, these 
being red in the warm and humid complexion, yellowish in the warm 
and dry, brownish in the cold and dry, and whitish in the cold and humid 
complexion. When, however, the complexion does not show any distinct 


characteristic, and varies but little from the average, Arculanus advises 
the teeth being filled with gold-leaf: *'Uhi non fuerit multus recessus 
a medtocritatey impleatur cum foliis auri.^' 

Although Arculanus is the first writer who alludes to the filling of 
teeth with gold, nevertheless it is by no means admissible that he was 
himself the inventor of gold filling. His words do not at all sound to us 
as the announcement of a new discovery, as the enunciation of a new 
fact, in which the author himself had had, at least, a part, be it great or 
small. Nothing of all this; the advice as to filling the teeth, in certain 
cases, with gold leaf is given quite impersonally, and is found, as if it 
were a point of minor importance, at the end of a long paragraph, 
which includes various other counsels in regard to the filling of teeth, one 
of which is, that this operation should not be performed with too great 
violence.* In short, the writer does not show the least intention of putting 
in evidence the aforesaid fact, or of giving to it any special importance. 
We must, therefore, hold that gold filling had already been in use for 
a long time among dentists, and that Arculanus simply mentions what 
was done by the dentists of those days. (See note page 164.) It is 
evident, on the other hand, that he had no special competence in dental 
art, when we consider that he was even ignorant of the exact number of 
dental roots. Naturally, the question here arises: At what period did 
gold begin to be used for the filling of teeth ? But unfortunately history 
has not, up to the present, furnished us any evidence which may lead to 
the solution of this problem. 

For the eradication of a tooth Arculanus gives three very precise indi- 
cations: (i) When the pain resists every other means of cure. (2) 
When there is any danger of the disease spreading to the neighboring 
healthy teeth. (3) When the tooth is troublesome in speaking and in 

Before extraction, the patient must be prepared for it by bloodletting, 
purgatives, and narcotics; and the operation must be commenced by 
separating the gums from the tooth. 

Arculanus admits, like many of his predecessors, that the eradication 
of a tooth may be effected not only by the forceps and other suitable 
instruments, but also by other means. One of these would be the use 
of the actual cautery, repeatedly applied inside the hollow of the tooth, if 
this is decayed; or, in the contrary case, made to act all around its root 

*'* Regimen autem implendo dentem corrosum est, ut impleatur in causa calida cum 
frigidis, et in frigida cum calidis. Secundo, ut non impleatur cum labore et vehementia 
addente in dolore, et ex propriis est gallia cum ciperis aut cum mastiche, et eligantur ex 
suprascnptis, calida aut frigida secundum opportunitatem, in contrarium dyscrasise dentis, 
sed ubi non fuerit multus recessus a mediocritate impleatur cum foliis auri." Cap. xlviii, 
p. 195. 


(neck). The fall of the tooth might also be obtained with potential 
cauteries and especially by the application of boiling oil, or of a grain of 
incense heated to the melting point. 

It is plain that Giovanni of Arcoli has simply copied these things from 
preceding authors, since if he had made a trial of the pretended eradicating 
means, he would soon have verified their inefficiency. 

Against hemorrhage of the gums, Arculanus recommends arsenic, 
lime, gall-nuts, alum, and oil of roses. But, says he, the surest remedy 
is the red-hot iron; and still more effectual, cauterization by means of 
red-hot gold. 

Giovanni of Arcoli's work is not only noteworthy because it mentions 
gold filling for the first time, but also because in it are given the drawings 
of three dental instruments, among which the pelican (here called puli- 
canuni). According to Carabelli, the first author who has mentioned the 
pelican was the Dutchman Peter Foreest ; according to Geist-Jacobi, 
instead, it was the German Walter Ryff. But both these statements 
are false, because as we have just now said, the pelican was already 
named and designed (not very well, it is true) in the book of the Italian 
Giovanni of Arcoli, who died in 1484, that is, even before either Walter 
Ryff or Peter Foreest came into the world. Neither does Giovanni of 
Arcoli say one word that might imply that he was the inventor of the peli- 
can, and so we are led to believe that in his days this instrument had 
already been in use for some time. In the text he only says: "The 
teeth are to be extracted with suitable instruments, whose figures may be 
seen in the margin."^ 

We here reproduce the three figures alluded to, with the relative indi- 
cations. The first (Fig. 56) represents the pelican; the second (Fig. 57) 
is a pair of curved forceps, which seems, in those days, to have been the 
instrument most commonly used for the extraction of teeth, since this 
figure is accompanied by the very generic indication "shape of the 
forceps for extracting teeth;" finally, the third (Fig. 58) represents the 
forceps used for extracting dental fragments (roots), and which from the 
long and straight shape of its jaws, was called "stork's bill" (rostrum 

Alessandro Benedetti, of Verona, who lived from 1460 to 1525, 
and taught medicine at Padua, was, for his times, a man of uncommon 
scientific merit; but to the development of the dental art he did not 
contribute anything very worthy of note. 

He relates that he once abstained from buying a slave simply because 

* In the Venetian edition (1542), however, all the figures which Arculanus inserted in his 
work are found in the beginning of the book, in a single table, together with the indica- 
tion of the use to which each single instrument was destined. 



the teeth of the latter were like those of wild beasts, a thing which he con- 
sidered as a bad omen. 

According to him, toothache is a disease proper to man, no other animal 
being liable to it. 

To keep free from odontalgia, there is, says he, a very simple means, 
which consists in rubbing the teeth once a year with the blood of a tortoise. 

This is the first writer who has noted the harmful effect which mercury 
has on the gums and teeth, whether this remedy be used internally or 
externally, that is, by friction. 


Fig. 56 



■ bmlU...«mm»« mm«m««»^mm4«^l 

The pelican as represented in Giovanni d'Arcoli's work. Forceps pro extrahendis 

dentibus pulicanum dicta. 

Fig. 57 

Dental forceps (Giovanni d'Arcoli). Forcipum pro extrahendis dentibus forma. 

Fig. 58 

The forceps called "stork's bill," as represented in Giovanni d'Arcoli's work. Forceps 

pro extrahendis fragment's quod Rostrum Ciconiae dicent. 

Benedetti recommends that before proceeding to the extraction of a 
tooth an accurate diagnosis should be made, so that it may not happen 
that, by mistaking for true odontalgia a pain localized in the gums or 
in the jaw, a sound tooth be drawn, under the belief that it is the cause 
of the pain; for, this happening, not only would the pain continue, but 
there would be, in addition, the loss of a sound tooth, and also the dis- 
advantage of the neighboring ones becoming less firm, for want of support. 

This author, too, attributes great importance to dental worms, believ- 
ing them to be one of the principal and most frequent causes of odon- 
talgia. To kill them he recommends the usual fumigations and several 


other remedies, among which the juice of the leaves of the centaury or 
of the peach tree, but especially applications of aqua vitae. 

When it is thought well to have recourse to opium to calm toothache, 
he advises this to be used with the utmost prudence ; and on this point, 
he relates having witnessed a fatal case, in the person of a gentleman of 
Padua, by the incautious use of this remedy. 

In extraction Benedetti repeats all the precautionary measures recom- 
mended by the ancients, and he, too, advises that recourse should not be 
had to this operation, if not as a last remedy, that is, when every other 
means of cure has been found useless.^ 

Giovanni of Vigo. The celebrated surgeon Giovanni of Vigo (1460 
to 1520), speaking of abscesses of the gums,^ says that the abscess must 
be first brought to maturity by fitting remedies, if it has not ripened spon- 
taneously, then it must be opened with a lancet, and lastly, to cleanse 
the diseased part and to aid cicatrization, honey of roses or Egyptian oint- 
ment must be used. This latter is thus composed of: **I^ — ^Verdigris, 
rock alum, ana two ounces; honey of roses, one ounce; plantain water 
and pomegranate wine, ana two and one-half ounces. The whole to be 
made to boil, and to be stirred with a small rod, until the mixture is 
reduced to the consistency of honey." 

For the cure of old fistulas he employs not only the above-mentioned 
Egyptian ointment, but also arsenic and corrosive sublimate. 

Giovanni of Vigo is very brief in speaking on the treatment of dental 
caries, doubtless because he attributed little or no value to the numerous 
methods of cure recommended by his predecessors. The treatment 
advised by him is, however, very noteworthy. He says that by means 
of a drill, file, scalpel, or other suitable instrument, it is necessary to 
remove the whole of the putrefied or corroded part of the teeth, and then, 
to preserve it, to fill the cavity with gold leaf. 

This clear and simple manner of speaking of gold filling as a cure for 
caries makes us suppose that Giovanni of Vigo was not at all a stranger 
to the practice of dentistry, as we must think of many preceding writers, 
but, on the contrary, that he was not less skilled in dental operations 
than he was in the other branches of surgery. Again, history tells us 
that Giovanni of Vigo was surgeon to the Roman court; so it would have 
been strange, indeed, if the Pope, if the haughty prelates, accustomed as 
they were to all kinds of refinement and comfort, should have intrusted 
the care of their teeth to lowborn barbers and quacks, whilst they could 
dispose of the services of so eminent a surgeon. 

' Alexandri Benedict! Veronensis de re medica opus, lib. vi, de affectibus dentium. 
'Opera domini Joannis de Vigo in chyrurgia. Lugduni, 1521, lib. ii, tract, iii, cap. xiv, 
fol. 40. 


It may, however, be seen from the very book of Giovanni of Vigo,^ 
that in his days doctors and surgeons were, in general, little skilled in 
dental matters. Speaking of the extraction of teeth, he says: "For 
this operation there is need of a practised man, and, therefore, many 
medical and surgical authorities have expressed an opinion that this 
operation should be left to expert barbers and to the itinerant quacks 
who operate in public places. He, therefore, who desires to perform 
this manual operation in the best manner will derive great advantage 
by frequenting men who are expert in performing it and by seeing and 
impressing well on his memory their manner of operating."' 

[* The editions and translations of Vigo seem to have been endless. A French trans- 
lation of his treatise on the wounds caused by firearms is said to have fallen into the 
hands of Pare, and had an inspiring influence upon the barber's boy. — C. M.] 

^ Lib. V, cap. v, De doloribus dentium, fol. cxvii to cxix. 




We have now arrived at the sixteenth century. The middle ages, 
that is, the period of transition between ancient and modern civilization, 
has now come to an end. Events of the highest importance, such as the 
invention of printing (1436), the taking of Constantinople by the Turks 
(1453), with the consequent emigration of many Greek men of letters 
and science, who took up their residence in the West and especially 
in Italy, and lastly, the discovery of America (1492), marked the begin- 
ning of a new era, and are the most essential factors in bringing about 
the revival of art and science. 

In the midst of the vigorous intellectual life which characterized the 
sixteenth century, dentistry, too, like many other branches of science, 
made very notable progress; we, therefore, in this period shall have to 
record many important facts and many important names. 

It is, indeed, in the sixteenth century, and, to be more precise, about the 
year 1544, that we meet for the first time with a monograph, in which 
dental affections are spoken of independently of general medicine and 
surgery. The book we allude to, by Walter Hermann Ryff, is also 
noteworthy because it is not written like the preceding works, in Latin, 
the customary language of the learned, but, instead, in German, that is, 
in a living tongue. 

As we are now mentioning the first German author on Dentistry, it 
may be permitted us briefly to glance at the beginning of medicine and 
dental art among the German peoples. 

Among the Germans, as in other nations, the first to practise the healing 
art were priests, priestesses, and wise women. To cure disease they 
used partly empirical remedies, and partly witchcraft and superstitious 
means of every kind. Thus, to facilitate dentition, it was thought an 
excellent thing to pass a thread through the eyes of a mouse and then to 


tie the blood-covered thread around the neck of the child. It was held, 
besides — and this prejudice has left even until now some traces — that the 
putting of the milk teeth, when they fall out, into the nest of a mouse 
assures the cutting of new teeth. 

We must here mention, with regard to the origin of dentistry among 
the Germans, a very important fact related by Joseph Linderer,* a fact 
which shows that even among the ancient Germans recourse was had to 
the application of artificial teeth. 

We here reproduce the very words of the said author, translated 

" Being by chance a few years ago at Dresden and visiting the Museum 
of Antiquities, my attention was attracted, in the last room, to two osseous 
pieces, which with other objects were enclosed in a glass case, with the 
written inscriptions : Comb-shaped osseous pieces^ found in ancient 
German urns. As soon as I had observed them, I saw at once that 
they were artificial teeth ; but as I had to be contented with examining 
them through the glass of the case, it was not possible for me to decide 
whether these pieces were really of bone, as they seemed to be, or of another 
substance. Taking into account their antiquity, their whiteness is very 
notable. Every piece is composed, if I remember rightly, of five teeth, 
that is, of a canine and four incisors ; the chief difference of these pieces 
from the prosthetic pieces in ivory still in use (the author is writing in 
1848) consists in this, that the pieces of which I speak have not at all a 
broad base, designed to rest on the gums, the base having instead the 
same thickness as the rest. The five teeth are well separated from one 
another. Besides, the canine makes the proper angle with the incisors, 
and at each side of the piece is found, in a convenient place, a hole, which 
shows that these teeth were fastened to those of the subject by means of 
a metallic or other kind of thread. As the above-described pieces are 
white, we must infer that they were removed from the mouth of the 
respective individuals before the body was burnt, and afterward put into 
the urn with the ashes, just as they used to put in coins, bits of arrows, 
and the like." 

For many centuries dental surgery — which, however, was still in a very 
primitive state — was practised in Germany, as in many other countries, 
principally by barbers. These in certain places, and at certain periods, 
formed corporate bodies, whose members were legally authorized to 
extract teeth and to practise minor surgery in general. But besides barbers, 
there were various kinds of individuals, unfurnished with any authoriza- 
tion — tooth-drawers, charlatans, wandering story-tellers, necromancers, 
Jews, and even hangmen — ^who invaded the field of medical practice, 

^ Handbuch der Zahnheilkunde, Berlin, 1848, ii, 406. 


in spite of its being forbidden them, except in fairs, to administer medica- 
ments and to perform surgical operations.' 

In 1460 there appeared in Germany a book on Surgery by Heinrich 
von Pfolsprundt, Knight of the Teutonic Order.' The author had 
acquired great experience as surgeon in the mlHtary expeditions of his 
order, and we see from his book that he was very skilled in the cure 
of wounds and fractures. On the other hand, he shows himself hostile 
to every bloody operation with the exception of rhinoplast. Pains of 
the teeth and gums were cured by him by means of beverages.^ 

0tgtteD 33uc^ 


(ffftcii wfy iKor<4^ti ter i3cctt/cKQ98(n 


iC«ntcU» Cdf% Mb tttHtmmi^ 


Title page of Zahnarzneybuchleii 

' Geisi-Jacobi, Geschichte der Zahnheilkunde, p. 80. 

* A religious order of knights, established toward the close of the twelfth century, 
during the third crusade. The original object of the association was to defend the Chrii 
religion against the infidels, and to take care of the sick in the Holy Land. 

* Geict-Jacobi, Geschichte der Zahnheilkunde, p. 8z. 


[The accompanying reproduction of the title page and two text pages from an edition 
of Zahnarxneybuchlein^ printed by Michael Blum, in Leipzig, 1530, and translated below, 
is of interest in connection with the history of the use of gold-foil as a filling material, 
in that a marginal note refers to Mesue as the author from whom the three methods of 
treating caries has been derived, one of these methods being the filling of the carious 
cavity with gold-foil. 

Mesue was Surgeon to the Caliph Haroun al Raschid, who flourished 786-809. If the 
reference to Mesue is correct, it would, therefore, indicate that the filling of teeth with 
gold was known to the Arabs as early as the latter part of the eighth century. Examina- 
tion of the writings of Mesue has thus far failed to bring to light any record therein of 
the treatment of caries by gold filling, although in his work previously referred to (see 
page 138) the other methods quoted by the anonymous author of Zahnarzneyhuchlein 
are fully set forth. 

©30 yunlft£apitteL 

^wn Senem 

C^rrofto iji erne ffrancF^de tonb t^e^el 
ber 501 xomn fie Mc^engff t)rtb ^ol n>r rbS 
iveb^d om twi^m ben hadtiml 9e(cl)td)t 
t>omem!<f Itci>ert fo em er ifl vnnX> fte ntc^e 
vw bar itnf>itiig^e fpetfe rctiiigct/n^elc^s 
ftttl notrbr/ v\\X> mad)t ^arnaay hS\c fc^l 
nrffe feitc^ttg^ett bte fte am fnfi im e^et/ 
vtib ^mmer all m eltd) vbaiyant n^mmct 
bafe fte aiic^ gaiiQ vn^ aar ^it yn Berber 
bet/x^itnb bamaci^mc^fcitfie fct^titerQeit 
m&ffefi fhlcFtd^t n^gt 0tiilett» 

tVTefue ^^^ ^^^ ^^ ^^ tYTefite fc^rei1>ee vwt 

vt ftn,«^wtfli4)brcveirle7we^ficiinre m mt4 

cavitt ^^^^' ^^ ^^f^^ '^^^ purgtnmg ab obeii 

pmi»» t^rt / 5ttm atibem mit refolmVunaber 

*^^ * maeertenbieftemtobolecmibit^eg^frtfi/ 

alfo b40 man IfodK ratten boa tm 0ont 

aber tx^e^tj n^ed^fi/mtt efjtge tmb im mtm 

be l[>albe/aber mtt efftge bo capptcBVO0t4 

Qel mtt ^^gn^er tnne gefotten tf{/x>nb ber 

glei4)en anbere remebta me^n 




Corrosion is a disease and defect of the teeth when they become carious and hollow, 
which most often happens in the molars, especially if one does not clean them of the 


adhering food which becomes moist and consequently produces bad, sharp [acid] moisture 
that eats and corrodes them, always gradually increasing, until it spoils the teeth entirely, 
which afterward must fall away in pieces not without pains. 

**Mesuf ut supra capite proprio." This, as Mesue writes, is chiefly cured and removed in 
three ways. First, by purging as treated upon above. Second, by dissolving the material 
which renders them hollow and eats them away; also by boiling cockles that grow in 
barley or wheat, in vinegar and holding this in the mouth. In this vinegar the root of 
caper and ginger and other similar remedies must have been previously boiled. Third, by 
removing the decay, which is done, in two ways. First, by scraping and cleaning the hole 
and the carious part with a fine chisel, knife, or Ble, or other suitable instrument, as is 
well known to practitioners, and then by filling the cavity with gold leaves for the preser- 
vation of the other portion of the tooth. Second, by using suitable medicine, such as 
oak apples or wild galls, with which the tooth is filled after having been cleaned. 

Sum tnteett bM ntM bie Aiia|>oIun9 
weg^ nimmct/wddfe and} anfiwc^ctle^ 
toe^ft Q€fd)id)t/ ^nm erfim bae man t>M 
loc^ vn^ Ote aufefrcffimQc mit mem fnb4 
tikft mciffc[d)tn abcv meffcrd)m vetlc^e/ 
abet mit cittern M^cm muniment battsn 
bcquemi(tUd)/w€^ fd)abe/vttX> teiniQc/ 
alo h'f practicf ^rttert tt?ol wiffenfvttb t>av^ 
in er$afoufig tea otiberti tc^lee X>es ianii 
^M tSd)lid)m mit golt blettern in f^Uet^ 
Znm anient X>m maim aebrandjc ertitc^ 
b^rju tmlid) W€l<i)e^efQ)ict mit (Bailee 
cpffel vnX> U)il0cr QatQen (o ber ictn nad) 
ter rtmtgurtg barmit wixbt QefilUu 

Vlim pUfctt famctt mit bem gnme fi^f 
xaci$vwmifii}t / vendue t>armittc bmd) 
tinen ttidyur hen Qd^d)ertm ^n» 

<Salbannm ifi tin gunimt glct(f>bem 
6libatt0anfft>ieaneQc^9lt€im gelegcr^ 
Imbertbeif fc^mcrQcm 

60 hie ^Icti $cffe mit ^p^pannac^ gc 
fuUet tt^erbm fhike e^r belt fa^merQm . 

(Corelleri ytfi^ffcn tonb in hie ^Im 3m 
fScUgt ntad)t ficanefaUen. 

The following editions of Zahttarzneybuchlein, besides the Basle and Mayence editions 
noted by Dr. Guerini at page i66, were issued and copies thereof are preserved in the 
libraries of the several collectors as stated. Edition of 1530, printed by Michael Blum, 
Leipzig, in collection of Edward C. Kirk. Edition of 1536, printed by Chr. EgenolfF, 
Frankfurt a/M, in collection of William H. Trueman. Edition of 1541, printed by Chr. 
EgenolfF, Frankfurt a/M, in Dental Cosmos library and collection of E. Sauvez. Edition 
of 1576, printed by Chr. EgenolfFserben, in collection of H. E. Friesell. — E. C. K.] 


The book, therefore, lacks importance from a dental point of view, 
except in the sense that it shows how little skilled in the cure of dental 
affections were the German surgeons of those days 

It is worthy of note that this author, also, speaks of anesthetic inha- 
lations; he, however, only translates, almost to a word, what Guy de 
Chauliac says on this subject. 

Toward the end of the fifteenth century and in the first half of the 
sixteenth there were published in German, by anonymous authors, some 
short translations and compilations on dental subjects, taken especially 
from Greek and Arabian authors/ Of these writings, the first one known, 
taken from Galen and Abulcasis, was printed at Basle in 1490; and 
another — one of the best — saw the light at Mayence in 1532. These 
works were perhaps due to intelligent barbers, or perhaps — and this 
seems to be the most probable — they were written, through the initiative 
of enterprising printers, by doctors and surgeons, who wished to remain 
unknown, on account of the special subject treated; for, owing to the fact 
that the diseases of the dental system were generally left in the hands of 
barbers and other unprofessional persons, the doctors and surgeons of 
those days would have been ashamed to interest themselves in such 

Walter Hermann Ryff, of Strasburg, was born in the beginning of 
the sixteenth century, and died about 1570. He was a rather mediocre 
doctor and surgeon, and a man of the worst morals, so much so that 
many cities expelled him from their midst.* He wrote many medical 
works, in which, however, there is very little original matter. Their 
principal merit consists, perhaps, in the fact that they were written not 
in Latin, as then was universally customary, but rather in the vernacular 
of the author and in a popular style; so that Ryff may be looked upon as 
the first who endeavored to diffuse among the people useful medical and 
hygienic knowledge. 

Among Ryff's books there are two which are very important to us. 
One is his Major Surgery^ and the other is a pamphlet entitled Useful 
Instruction on the Way to Keep Healthyy to Strengthen and Reinvigorate 
the Eyes and the Sight. fVith Further Instruction on the Way of Keeping 
the Mouth Freshy the Teeth Clean^ and the Gums Firm} 

Of these books, there now only exist some extremely rare copies ; so 
much so that neither Albert von Haller nor Kurt and Wilhelm Sprengel, 
who rendered such great services to the history of surgery, ever had the 
pleasure of examining them. Dr. Geist-Jacobi has been more fortunate 

* Geist-Jacobi, p. 88. " Albert von Haller, Bibliotheca chirurgica, i, 190. 

' Nuetzlicher Bericht, wie man die Augen und das Gesicht schaerfen und gesund erhalten, 
die Zaehne frisch und fest erhalten soil. Wiirzburg, 1548. 


than they, and has therefore been able to give us some very interesting 
information about their contents. 

The Major Surgery is a mere compilation which does not contain 
anything new of importance. It was published in part in 1545, and 
in part in 1572, after the death of the author. The work is illustrated 
with very beautiful wood engravings; and it is just this which gives the 
principal value to this book. Some of the illustrations contained in the 
Brst part of it — that is, in that published in 1545 — represent dental instru- 
ments, notwithstanding dental surgery is not treated in this part of 
the book. The author gives notice that he will treat all that concerns 
dental affections in the latter part of this book, in a special chapter. 
Unfortunately, this chapter was never written, because death prevented 
RyfF from completing the second part of his work. 

Fig. 59 

Pelican and dental forceps (Walter Hermann Ryff), 

The dental instruments represented in his Major Surgery are many in 
number. Among them, first of all, are found the fourteen dental scrapers 
of Abulcasis, then the " duck-bill" — designed for the extraction of dental 
roots and broken teeth — various kinds of pelican (Fig. 59 a), the " common 
dental forceps" (Fig. 59 b), the "goat's foot," and many other kinds of 
elevators, among which, observes Geist-Jacobi, may be seen instruments 
even now in use, and even some which are said to have been recently 

RylTs other book is especially noteworthy because, as we have already 
mentioned, it treats, for the first time, of dental matters, independently 


of general medicine and surgery. This pamphlet, printed at Wiirz- 
burg about the year 1544, is made up of sixty-one pages, and is divided 
into three parts, the first of which is dedicated to the eyes, the second to 
the teeth, and the third to the first dentition. It is written in popular 
style, and the author certainly intended it for the instruction of the 
public, and not for professional men; so true is this, that in it he does not 
speak of the technical part of the extraction of teeth, or of gold filling — 
a method already known for a long time — or of dental prosthesis. 

The first part, relative to diseases of the eyes and the manner of curing 
them, has no importance for us. The second part begins with the 
following paragraph : 

"The eyes and the teeth have an extraordinary affinity or reciprocal 
relation to one another, by which they very easily communicate to each 
other their defects and diseases, so that the one cannot be perfectly healthy 
without the other being so too."* 

This last statement is absolutely false, as a disease of the eyes may 
very well exist with a perfect condition of the teeth, and vice versa. 
However, RyflF has the merit of being, perhaps, the first who has noted 
the undeniable relation which exists between the dental and ocular aflFec- 

After a rapid glance at the anatomy and physiology of the teeth, the 
author enumerates the causes of dental disease, which, according to him, 
are principally heat, cold, the gathering of humors, and traumatic actions. 

The prophylaxis of dental diseases is beyond any doubt one of the 
best parts of the book; however, the ten rules counselled by RyfF for 
keeping the teeth healthy — rules which Dr. Geist-Jacobi has made 
known to us in full — are reproduced, almost to a word, from Giovanni 
d'Arcoli's work; therefore, the author has no other merit than that of 
having translated them into the vulgar tongue, thus diffusing the knowl- 
edge of useful precepts for preventing dental diseases. We refrain from 
reproducing the aforesaid rules here, as they are, with slight variations, 
identical with those which we gave when speaking of Arculanus. 

Nor can any credit be given to RyflF for the rules which he gives in 
regard to the diagnosis of dental pains, as this part of his work is also 
taken wholly from the Italian author just mentioned. 

After these diagnostic rules RyflF, continuing to translate from the book 
of Giovanni d'Arcoli, adds: 

" If the pain comes from the gums, extraction is of no use; if it comes 
from the tooth, extraction makes it cease; when, lastly, it is in the nerve, 
sometimes extraction removes it, and sometimes it does not, according as 
the matter obtains or not a free exit." 

* See Giomale di Corrispondenza pei dentisti, 1895, xxiv, 289. 


The barbers and tooth-drawers, he says, must well remember this 
rule, in order to avoid extracting, thoughtlessly and with no benefit, 
sound teeth, since then the pain persists in spite of the operation. Also, 
it must be borne in mind that, in case of violent pain, it is necessary 
to operate as soon as possible, so that the patient may not faint or be 
attacked by the falling sickness, if the pain should be communicated to 
the heart or brain. 

The idea that violent dental pains could give rise to syncope or to epi- 
lepsy (in regard to which we only observe that even very recent writers 
enumerate dental caries among the causes of the so-called reflex epilepsy) 
is also found in Giovanni d'Arcoli, who expresses himself in regard to this 
in the following terms: "Such very violent pains are sometimes followed 
by syncope or epilepsy, through injury communicated to the heart or 

"The most atrocious pain," says RyflF, "is when an apostema ripens 
in the root;*' literal translation of words written about a century before 
by Arculanus: "Fortissima dolor est, qui provenit ab apostemate, quod 
in radice dentis maturatur." 

Likewise taken from Arculanus is the observation (already made, 
however, by much more ancient writers) that "when the cheeks swell, 
toothache ceases." Arculanus, however, expresses himself in a less 
absolute manner, and therefore more corresponding to the truth, since 
he says "the pain generally ceases" (secundum plurimum dolor sedatur). 

Even in regard to the therapeutics of dental pains, RyfF does not 
tell us anything new. Dr. Geist-Jacobi gives this author the merit of 
having made, in regard to the cure of dental pains, a distinction between 
cura mendosa (that is, imperfect, palliative, tending simply to calm the 
pain) and cura vera (that is, directed against the causes of the disease). 
But this very important distinction is also taken from Arculanus, who in 
his turn took it from Mesue. In fact, after having spoken of the general 
rules relative to the cure of dental diseases, Giovanni of Arcoli adds : 
"As to the particular therapy, it is divided into cura mendosa and cura 
veray as may be found in Mesue. And the cura mendosa is so called 
because it calms the pain by abolishing sensibility, not by taking away 
the cause of it. Such is, for the sake of example, the cure, consisting in 
fumigations of henbane, made to reach the diseased tooth by means of 
a small tube, adapted to a funnel." 

The third part of RyflF's pamphlet has as its title : 

" How the pains of the gums should be calmed or mitigated in suckling 
infants, so as to promote the cutting of the teeth without pain." 

This part, as Geist-Jacobi informs us, is very brief, not taking up more 

' Joannis Arculani. Commentaria, Venetiis, 1542, cap. xlviii, De dolore dentium, p. 192. 


than a page and one-half of print. Neither does it contain anything of 
importance. To render the cutting of teeth easier, Ryff advises that 
infants should have little wax candles given to them to chew and the 
gums anointed with butter, duck's fat, hare's brains, and the like. The 
tooth of a wolf may be hung around the neck of the child, so that it may 
gnaw at it. It is also recommended that the head of the child should be 
bathed with an infusion of chamomile. 

From what has been said, one may see very clearly that the aforesaid 
book is, from the scientific point of view, entirely valueless, because 
the best part of it is merely copied from the work of Giovanni d'Arcoli. 
However, the author has the indisputable merit of having endeavored 
to diffuse the knowledge of useful precepts of dental hygiene. His book, 
besides, we repeat, has great historical value, for from it dates the 
beginning of odontologic literature, properly so called. 

On this point we believe it is necessary to correct an error into which 
Dr. Geist-Jacobi has fallen. At the beginning of his very valuable article 
on Walter Hermann Ryff^ he says: "In the fifth century of the Christian 
era, the iatrosophist Adamantius of Alexandria published an exclusively 
odontalgic work, of which, however, we only know the title." The 
same he repeats in his History of Dental Art (pp. 55 and 56), without, 
however, giving us any proof of his statement. "Of the odontologic 
treatise of Adamantius," he says, "unfortunately the title alone is known 
to us, and even that has reached us indirectly, that is, by means of ^tius; 
it is of the following tenor." 

Now, whoever takes the trouble to translate these Greek words will 
easily perceive that they do not constitute one title, but two distinct ones 
(which even Dr. Geist-Jacobi has had to unite by the conjunction and). 
These, however, are nothing more than the titles of two chapters of the 
Tetrabiblos of ^tius, as anyone may see for himself by turning over the 
pages of this work either in the Greek original, or in the beautiful Latin 
translation of Giano Cornario (Venice, 1553). In this great composition 
of ^tius dental diseases are treated of in Chapters XXVII to XXXV of 
Sermo IV, Tetrabiblos II; and the two Greek titles above referred to 
are the titles of Chapters XXVII and XXXI. 

In the translation of Giano Cornario they read as follows: 

Cura dentium a calido morbo doloroso affectoruniy ex Adamantio sophista 
(cure of teeth affected by warm, painful disease, according to Adaman- 
tius the sophist). 

Cura dentium a stccitate dolore affectorum^ ex Adamantio sophista 
(cure of teeth affected by pain from dryness, according to Adamantius 
the sophist). 

* "The first dental book in the German language*' (see Giomale di Corrispondenza 
pei dentisti, loc. cit.). 


The work of Adamantius, from which ^tius took the contents of the 
chapters thus entitled, is lost to us, but we have no reason, and not even 
the least indication, for supposing that this work was a treatise on dental 
diseases, and not one on general medicine. It is absurd to consider the 
above-mentioned titles as belonging to an odontological monograph, 
on the one hand, because, admitting for a moment the existence of such 
a work, it should have had but one title and not two, and on the other 
hand, because it is by no means to be supposed that a great and wise 
physician, such as Adamantius undoubtedly was, should have had the 
whim to write a book, not on dental disease or on dental pains in general, 
but only and exclusively on dental pains caused by heat or by dryness. 
What reason would there have been for not extending the treatment of 
the subject to those cases of odontalgia resulting from humidity or from 
cold, that is, from causes as common and, according to the ideas of that 
time, very frequently associated with one of the first two (as humidity 
with heat, and cold with dryness) ? 

Besides, if the titles of the two chapters spoken of be compared with 
those of the others, in which ^tius treats of dental affections, such analogy 
will be noticed between the various titles as to make us consider that 
they have been formulated by ^Etius himself, even when the contents of 
these chapters are taken from other writers. So that the two aforesaid 
titles not only do not belong to any dental work, but probably they 
have never existed, even as simple titles of chapters, in the medical book 
of Adamantius, from which the contents of the two chapters of ^Etius 
above mentioned have been taken. 

In order that every one may easily be convinced that the two titles 
made so conspicuous by Dr. Geist-Jacobi have nothing particular about 
them, but are, instead, perfectly analogous to the titles of various other 
chapters of ^Etius, we give here the translation of the titles of five chapters, 
all concerning dental maladies, that is, the two chapters in discussion 
and other three: 

Chapter XXVII: Cure of teeth affected by warm, painful disease, 
according to Adamantius the sophist. 

Chapter XXIX: Cure of teeth affected with pain from humidity. 

Chapter XXXI : Cure of teeth affected by pain from dryness, according 
to Adamantius the sophist. 

Chapter XXXII: Cure of teeth affected by pain from heat and 

Chapter XXXIII: Cure of decayed teeth, according to Galen. 

It appears very clear, therefore, from the great analogy existing between 
the headings of all the above-mentioned chapters, that the titles referred 
to by Geist-Jacobi have not at all the historical importance and signifi- 
cance that he attributes to them, and that the same have been formulated 


by iEtius himself. To argue from such titles that Adamantius was the 
author of a book on dentistry is not only inadmissible, for all the reasons 
already given, but also because if it were allowable to reason with such 
lightness, it might also be stated — by arguing from the title of Chapter 
XXXIII — that Galen was the author of a monograph on the treatment 
of dental caries; a thing which is absolutely untrue. Consequently, the 
beginning of odontologic literature cannot be traced back to Adaman- 
tius, but, as Dr. Geist-Jacobi would have it, to an author much less 
ancient, that is, to Walter Hermann Ryff, or, if it is preferred, even to the 
anonymous writers of the odontologic compilations which appeared in 
Germany at the end of the fifteenth century. 

Andreas Vesalius. We must now speak of Andreas Vesalius, an 
extraordinary man, who by his genius infused new life into medical 
science, and who, although he gave but little attention to dental matters, 
yet fully deserves a place of honor in the history of dentistry ; for this, 
like every other branch of medicine, received great advantage from 
his reforming work, which broke down forever the authority of Galen, 
thus freeing the minds of medical men from an enslavement which 
made every real progress impossible. 

Andreas Vesalius was born at Brussels, December 31, 1514. He 
studied at Louvain and then at Paris, where at that time great scientists 
taught, and among others the celebrated anatomist Jacques Dubois, 
generally known by the Latinized name of Sylvius.* The latter, a great 
admirer of Galen, whose anatomical writings served as texts for his 
lectures, became jealous of the young Belgian student, who was his assist- 
ant, and who gave undoubted proofs of great genius, and of extraordinary 
passion in anatomical research. Vesalius often defied the greatest 
dangers in order to obtain corpses either from the cemetery of the Inno- 
cents or from the scaffold at Montfaucon. He soon surpassed his most 
illustrious masters, and at only twenty-five years of age published splendid 
anatomical plates, which astonished the learned. He acquired also great 
renown as surgeon, and in this capacity he followed the army of Charles 
V in one of his wars against France. After having been professor of 
anatomy in the celebrated University of Louvain (Belgium), he was 
invited by the Venetian Republic to teach in the University of Padua, 
which, through him, became the first anatomical school in Europe. 
Yielding to the requests of the magistrates of Bologna and Pisa, he also 
taught in those famous universities, before immense audiences. 

Before Vesalius, Galen's anatomy had served as the constant basis for 
the teaching of this science. Although even from the end of the fifteenth 
century dead bodies were dissected in all the principal universities, the 

' A Latin translation of the French name Du hois. 


teachers of anatomy always conformed, in their descriptions, to those of 
Galen, so that the authority of this master, held infallible, prevailed even 
over the reality of facts. 

Vesalius, for the first time, dared to unveil and clearly put in evidence 
the errors of Galen ; but this made him many enemies among the blind 
followers and worshippers of that demigod of medicine. Europe re- 
sounded with the invectives that were bestowed upon Vesalius. Among 
others, there rose against him Eustachio at Rome, Dryander at Marburg, 
Sylvius at Paris, and this last did not spare any calumny that might 
degrade his old pupil, who had become so celebrated. In spite of this, 
the fame of Vesalius kept on growing more and more, so much so that 
Charles V called him to Madrid, to the post of chief physician of his 
Court, a place which he kept under Philip II, also after the abdication 
of Charles V. The good fortune of Vesalius, unhappily, was not to 
be of long duration. In 1564 a Spanish gentleman died, in spite of the 
care bestowed upon him by Vesalius, and the illustrious scientist requested 
from the family, and with difficulty obtained, the permission to dissect 
the body. At the moment in which the thoracic cavity was opened the 
heart was seen, or thought to be seen, beating. The matter reached the 
ears of the relations of the deceased, and they accused Vesalius, before 
the Inquisition, of murder and sacrilege; and he certainly would not have 
escaped death except by the intervention of Philip II, who, to save him, 
desired that he should go on a pilgrimage to the Holy Land, as an expia- 
tion. On his return, the ship which carried Vesalius was wrecked, and 
he was cast on a desert beach of the Isle of Zante, where, according to 
the testimony of a Venetian traveller, he died of hunger, October 15, 1564. 

Vesalius left to the world an immortal monument, his splendid treatise 
on Anatomy,* published by him when only twenty-eight years of age, 
and of which, from 1543 to 1725, not less than fifteen editions were issued. 
The appearance of this work marked the commencement of a new 
era. The struggle between the supporters of Galen and those of Vesa- 
lius rendered necessary, on both sides, active research concerning the 
structure of the human body, so that anatomy, the principal basis of 
scientific medicine, gradually became more and more perfect, and, as 
a consequence of this, as well as of the importance which the direct 
observation of facts acquired over the authority of the ancients, there 
began in all branches of medicine a continual, ever-increasing progress, 
which gave and still gives splendid results, such as would have been 
impossible under the dominion of Galenic dogmatism. 

In the great work of Vesalius the anatomy of the teeth is unfortunately 
treated with much less accuracy than that of the other parts of the body. 

^ De humani corporis fabrica, libri septem. 


However, his description of the dental apparatus^ is far more exact 
than that of Galen, and represents real progress. The number of the 
roots of the molar teeth (large and small) is indicated by Galen in a 
very vague and inexact manner, since he says that the ten upper molars 
have generally three, sometimes four roots, and that the lower ones have 
generally two, and rarely three. Vesalius, having examined the teeth 
and the number of their roots in a great number of skulls, was able to 
be much more precise. In regard to roots, he makes, for the first time, 
a very clear distinction between the premolars next to the canine (small 
molars) and the other three, and says that the former in the upper jaw 
usually have two roots, and in the lower, one only, whilst the last three 
upper molars usually have three roots and the lower ones two. As 
everyone sees, these indications are, in the main, exact. 

Other important facts established by Vesalius are as follows: 

The canines are, of all the teeth, those which have the longest roots. 
The middle upper incisors are larger and broader than the lateral ones, 
and their roots are longer. The roots of the last molars are smaller than 
those of the two preceding molars. In the penultimate and antepenulti- 
mate molars, more often than in the other teeth, it sometimes happens 
that a greater number of roots than usual are found, it being not very 
rare to meet with upper molars with four roots, and lower ones with three. 
The molars are not always five in each half jaw; sometimes there are 
only four, either on each side, or on one side only, in only one jaw or in 
both. Such differences generally depend on the last molar, which does 
not always appear externally, remaining sometimes completely hidden 
in the maxillary bone, or only just piercing with some of its cusps the thin 
plate of bone which covers it; a thing which Vesalius could observe in 
many skulls in the cemeteries. 

In regard to the last molar, the author speaks of its tardy eruption 
and of the violent pains which not unfrequently accompany it. The 
doctors, he adds, not recognizing the cause of the pain, to make it cease 
have recourse to the extraction of teeth, or else, attributing it to some 
defects of the humors, overwhelm the sufferer with pills and other internal 
remedies, whereas the best remedy would have been the scarification of 
the gums in the region of the last molar and sometimes the piercing of 
the osseous plate which covers it. 

This curative method, of which no one can fail to recognize the im- 
portance, was experimented by Vesalius on himself, in his twenty-sixth 
year, precisely at the time that he had just begun to write his great treatise 
on anatomy. 

* De humani corporis fabrica libri septem, cap. xi, De dentibus, pp. 40 to 42 (complete 
edition of the works of Vesalius, published at Leyden in 1725). 


The existence of the central chamber of the teeth appears to have 
been unknown to Galen, as he does not allude to it in the least. Vesalius 
was the first to put this most important anatomical fact in evidence. He 
expresses an opinion that the central cavity facilitates the nutrition of 
the tooth. He says, besides, that when a hole is produced in a tooth 
by reason of acrid corrosive humors, the corrosion, when once the internal 
cavity is reached, spreads rapidly and deeply in the tooth, owing to the 
existence of the said cavity, and sometimes reaches even the end of 
the root. 

In the chapter in which Vesalius treats of the anatomy of the teeth 
(Chapter XI, p. 40), two very well-drawn figures are found, one of which 
represents a section of a lower molar, showing the pulp cavity and its 
prolongation into the two root canals. The other represents the upper and 
lower teeth of the right side, in their reciprocal positions, and shows very 
clearly their general shape, the length of their roots, and the numberof these. 

The changes which take place in the alveolus, after the extraction of 
a tooth have not escaped the notice of Vesalius. He says that after an 
extraction the walls of the alveolus approach one another, and the cavity 
is gradually obliterated. 

Aristotle had affirmed that men have a greater number of teeth than 
women. Vesalius declares this opinion absolutely false — although, after 
Aristotle, it has been repeated by many other ancient writers — and says 
that anyone can convince himself that the assertion of Aristotle is con- 
trary to the truth, as it is possible for everybody to count his own teeth. 

In spite of this, we find the above-mentioned error even in writers 
subsequent to Vesalius; for example, in Heurnius (professor at Leyden 
toward the end of the sixteenth century), who expresses an opinion 
that rarely do women have thirty-two teeth, like men. 

We find but little in Vesalius concerning the development of the teeth. 
He, indeed, made some observations and researches on this point, but 
these, from their insufficiency, led him to quite mistaken conclusions. 
The teeth of children, he says, have imperfect, soft, and, as it were, medul- 
lary roots ; and the part of the tooth which appears above the gums is 
united to the root, so to say, as a mere appendix, after the fall of which 
there grows from the root the permanent tooth. This error arose in the 
mind of Vesalius from observing that when children lose their milk teeth, 
these have the appearance of a kind of stump, as if the root had actually 
remained in the socket. Besides this, he had observed with what facility 
the milk teeth fall out; and he here calls to mind that, when about seven 
years old, he himself and his companions used to pluck out their loosened 
teeth, and especially the incisors, with their fingers, or with a thread tied 
around the tooth. The softness of the dental roots in children, the easy 
fall of the milk teeth, and the want of the lower part of the roots in these. 


must have raised the idea in his mind that the roots of the milk teeth 
remained in the socket, and that the upper part of the temporary teeth, 
instead of being a continuation of the root, was joined to this as a simple 
appendix, and in a very weak way, as though designed to remain in place 
for a limited length of time only. 

In Vesalius* is found a dental terminology — Latin, Greek, Hebrew, 
and Arabic — which affords some interest. The incisors are called in 
Latin incisoriij risorii\ quaterniy quadrupli; and the two middle incisors 
have been denominated by some authors duales. The canines are called 
in Greek kynodontes, which means the same as the Latin caniniy dog's 
teeth. In Latin they have been also denominated morJenteSy and by some 
also risoriiy 2l name which by others is given to the incisors, as we have 
already seen. The molars have also been called in Latin maxillares^ 
paxillaresy mensaleSy genuini^ But some authors give this last name 
only to the last molars, or wisdom teeth, denies sensus et sapientia et 
intellectus. These teeth have also been called serotini (that is, tardy), 
cetatem complentes (that is, completing the age, the growth), and also, 
in barbaric Latin, cayseles or caysalesy negugidiy etc. 

In the rebellion against the authority of the ancients, Vesalius 
had a predecessor whose name, deservedly famous, may be recorded 
here. Paracelsus (born in 1493 at Maria-Einsiedeln, Switzerland), on 
being nominated, in 1527, Professor of Medicine and Surgery at Basle, 
inaugurated his lectures by burning in the presence of his audience, who 
were stunned by such temerity, the writings of Galen and Avicenna, 
just as Luther, seven years before, had burnt in the public square of 
Wittenberg the papal bulls and decretals. The sixteenth century, in 
its exuberance of intellectual life, was undoubtedly one of the grandest 
centuries in history ; human thought in that glorious epoch shattered its 
chains, and declared its freedom both in matters of science and of religion. 

Paracelsus, a man of powerful genius, but not well balanced in mind, 
of corrupt morals, and of an unlimited pride, had, notwithstanding these 
undeniable defects, the merit of beginning a healthy reform in the science 
and practice of medicine, by substituting the study of nature for the author- 
ity of the ancients and by giving a great importance to chemistry, both for 
the explanation of organic phenomena and for the cure of disease. 

It is to be lamented that this man of genius did not contribute in any 
way to the progress of dentistry. His works have no importance for us. 
As a matter of mere curiosity we only record here that Paracelsus con- 
sidered the too precocious development of the teeth as a great anomaly, 
and regarded as monsters those children who were born with teeth.' 

' Lib. i, cap. xlii, p. 141. ^ From gena^ a cheek. 

^ Blandin, Anatomie du systeme dentaire, Paris, 1836, p ig 


GiAN FiLiPPO Ingrassia (1510 to 1580), a distinguished Sicilian 
anatomist, was one of the first who spoke of the dental germ. He says 
that the existence of the tooth properly so called is preceded by that 
of a soft dental substance enclosed in the bone, and which he considers 
almost as a secretion of the latter. 

Matted Realdo Colombo, of Cremona, a pupil of Vesalius and his 
successor in the professorship of Anatomy at Padua, added but little, 
as regards the teeth, to what his master has taught. He combated 
the erroneous idea that the teeth were formed in the alveoli shortly 
before their eruption. Having dissected the jaws of many fetuses, and 
having always observed in them the existence of teeth, he could affirm 
with every certainty that the teeth begin to be formed in intra-uterine 

Like Vesalius, Realdo Colombo believed that the permanent teeth 
were developed from the roots of the milk teeth; and, therefore, he 
advised the utmost caution in extracting these, since, if the whole root 
were removed, the tooth would not grow again. ^ 

Gabriel Fallopius (1523 to 1562), the eminent anatomist of Modena, 
also a disciple of Vesalius, carried out accurate and successful researches 
in regard to the development of the teeth, and made them known in his 
book, Observationes anatomic(By published at Venice in 1562, the year 
in which he died. 

His investigations enabled him to show the falsity of the opinion held 
by Vesalius, that the permanent teeth are developed from the roots of 
the temporary ones. He was, besides, the first who spoke in clear terms 
of the dental follicle. 

The teeth, says Fallopius,^ are generated twice over, that is, the first 
time in the uterus, after the formation of the jaws, and the second time in 
extra-uterine life, before the seventh year. The first teeth are, at the 
time of birth, still imperfect, without roots, completely enclosed in their 
alveoli, and formed of two different substances; the part with which they 
must break their way out is osseous and hollowed; the deeper part, in- 
stead, is soft and humid and is seen covered with a thin pellicle, a thing 
which may also be observed in the feathers of birds when they are still 
tender. In fact, the part of the feather which comes out of the skin 
is hard and corneous, whilst the part which is embedded in the wings is 
soft and humid and has the appearance of coagulated blood or mucus. 
So also in the fetal teeth, the part corresponding to the future root presents 
itself like coagulated mucus. Little by little this soft substance hardens 
and becomes osseous, thus constituting the root of the tooth. 

* Portal, Histoire de I'anatomie et de la chirurgie, tome i, p. 545. 
' Observationes anatomicae, p. 39, et seq. 


Fallopius' reference to the analogy between the development of teeth 
and that of feathers was highly important, as a point of departure for 
embryological researches which showed clearly the real nature of teeth, 
thus destroying the mistaken idea — held by Galen and many other authors 
— that these organs were bones. 

On coming to speak of the teeth generated in extra-uterine life, that 
is of the permanent teeth, Fallopius relates having observed that they 
have their origin in the following manner: A membranous follicle is 
formed inside the bone furnished with two apices, one posterior (that is 
to say, deeper down, more distant from the surface of the gums), to which 
is joined a small nerve, a small artery, and a small vein {cui nervulusy 
et arterioloy et venula applicantur); the other anterior (that is more super- 
ficial), which terminates in a filament or small string, like a tail. This 
string reaches right to the gum, passing through a very narrow aperture 
in the bone, by the side of the tooth which is to be substituted by the new 
one. Inside the follicle is formed a special white and tenacious substance, 
and from this the tooth itself, which at first is osseous only in the part 
nearest the surface, whilst the deeper part is still soft, that is, formed of 
the above-mentioned substance. Each tooth comes out traversing and 
widening the narrow aperture through which the "tail" of the follicle 
passes. The latter breaks, and the tooth comes out of the gum, bare 
and hard; and in process of time the formation of its deeper part is 

The author says that his long and laborious researches into the develop- 
ment of the teeth were carried out with great accuracy, and he is, there- 
fore, in a position to give as absolute certainties the facts exposed by 
him. Indeed, the observations of Fallopius were, for the most part, 
confirmed by subsequent research. As to the "tail" of the dental follicle, 
it is identical with the iter dentis or gubernaculum dentis of some authors. 
Fallopius described it as a simple string, but later on this prolongation 
of the dental follicle has been considered, at least by some, as the nar- 
rowest part or neck of the follicle itself, that is, as a channel through 
which the tooth passes, widening it, on its way out, and precisely for this 
reason it has been called iter dentis (the way of the tooth) or gubernaculum 
dentis (helm or guide of the tooth). 

Bartholomeus Eustachius, another great anatomist of the sixteenth 
century, occupied himself in the study of teeth with special interest, and 
wrote a very valuable monograph on this subject. He was a native of 
San Severino, Marche (Italy), and a contemporary of Vesalius, Ingrassia, 
Realdo Colombo, and Fallopius; he died in 1574, after having immortal- 
ized his name through many anatomical discoveries and writings of the 
highest value. 

His book on the teeth, Libellus de dentibusy published at Venice in 1563, 


is the first treatise ever written on the anatomy of teeth, and represents a 
noteworthy progress in this branch of study. 

In this little book — divided into thirty chapters, forming in all ninety- 
five pages — the author treats with great accuracy and in an admirable 
manner all that concerns the anatomy, physiology, and development 
of the teeth. 

Eustachius not only treasured up what ancient authors had written 
on this subject, but he himself made very long and patient researches and 
observations on men and animals, on living individuals as well as on 
corpses, and not only on adult subjects, but also on children of every age, 
on stillborn children and on abortive fetuses. 

The macroscopic anatomy of the teeth was brought by him to a high 
degree of perfection. Very wonderful, among other things, is the accuracy 
with which he studied and specified in several synoptical tables the number 
of the roots of molar teeth, and all the variations occurring not only in 
their number, but also in their form, length, etc. 

In Chapter IV, speaking of the means by which teeth are held in their 
sockets, Eustachius mentions in quite explicit terms the ligaments of the 
teeth. He begins by saying that the perfect correspondence between the 
dental roots and the alveoli, both in shape and in size, is one of the elements 
which contribute to the firmness of the teeth, since the alveolus, being 
exactly applied, on all sides, to the root or roots of the tooth, causes the 
latter, by this simple fact, to be fixed in a determined position. Also, 
the nerves inserted in each single tooth contribute, as was already the 
opinion of Galen, to the stability of these organs. "There exist besides" 
— Eustachius continues — "very strong ligaments, principally attached 
to the roots, by which these latter are tightly connected with the alveoli" 
(adsunt praterea vinculo fortissima radicibus prcecipue adherentiay quibus 
prasepiolis arctissime colligantur). Lastly, says the author, the gums, 
too, embracing the teeth at their exit from the alveoli, contribute to their 
firmness. And here Eustachius notes that in the joining of the gums to 
the teeth there is great analogy to that of the skin with the finger nails; 
a very proper observation, which makes us almost suppose that the 
perspicacious mind of Eustachius may have guessed the kindred nature 
of nails and teeth. 

In Chapter XV are related the researches made by the author to ascer- 
tain at what period the development of the teeth begins. Here is a passage 
of this chapter, almost literally translated: 

" Hippocrates, before anyone else, wrote that the first teeth are formed 
in the uterus. Wishing to assure myself thereof, I dissected many 
abortive fetuses, and by very careful observations I found it to be true 
that the teeth have their origin during intra-uterine life. Wherefore, the 
opinion of those who consider that the first teeth are formed from the milk, 


and those of the second dentition from food and drink, must be declared 
entirely false. In fact, by opening both jaws of a stillborn fetus, one 
may find, on each side of each jaw, the incisors, the canine, and three 
molars, partly mucous and partly osseous, and already sufficiently 
large and entirely surrounded by their alveoli. Then removing, with a 
skilful hand, the incisors and the canines, there may be observed a very 
thin partition only just ossified; and if this be removed with equal care, 
an equal number of incisors and canines, almost mucous and very much 
smaller, appear, which, enclosed in special alveoli behind the first, would 
exactly correspond in position each with its congener, if in both jaws 
the canine were not resting for the greater part on the next incisor so as 
almost to hide it." 

As to the molars (by which name also the bicuspids are here meant), 
Eustachius says that he found but three on each side, and no trace what- 
ever of the others. Nevertheless, he considers it quite probable that the 
germs of the latter should also exist in the fetus, although so small as to 
escape observation. He gives many ingenious reasons in support of his 
mode of thinking, and comes to the general conclusion, that not only 
the temporary teeth but also the permanent ones have, all of them, their 
origin during fetal life; a false conclusion simply because too general, 
and which shows once more how, in biological science, one runs great 
risk of falling into error whenever one tries to draw too free deductions 
from observed phenomena. 

The researches of Fallopius and Eustachius confirm and complete each 
other. These two eminent anatomists, who gave great glory to Italy 
by their immortal discoveries and works, were the first to shed a brilliant 
light upon the development of the teeth, and thus opened up the way to 
all subsequent research on odontogeny. 

In settling the period in which the formation of the teeth begins, 
Fallopius was still more successful than Eustachius. His patient investi- 
gations showed him that the development of the teeth commences partly 
in the uterus and partly after birth, which is perfectly true, as was made 
clear by later embryological researches. Fallopius found in each fetal 
jaw twelve teeth. ^ In this he agrees perfectly with his contemporary, 
Eustachius, who, as we have seen a short while ago, found in fetusus, 
only just born, the incisors, the canines, and three molars for each side of 
each jaw. Eustachius, however, observed in the fetus the germs of the 
permanent incisors and canines as well, a thing not noted by Fallopius. 

It is not to be wondered at that some discrepancy should exist between 

* In utero duodocim denies formantur in malts, et totidem in maxilla (in the uterus are 
formed twelve teeth in the upper jaw and as many in the lower). Fallopii Gabrielis observa- 
tiones anatomicx, Venetiis, 1562, p. 39. 


the observations of these two eminent anatomists. The researches of 
which we are speaking are sufficiently delicate and difficult; and even much 
more recent authors are far from agreeing perfectly, as far as regards the 
period, in which the development of the teeth begins. Serres, in his Essai 
sur Vanatomie et la physiologie des dents (Paris, 1817), sustains the view 
that in the fetus he has observed the germs of all the teeth, both temporary 
and permanent, while Joseph Linderer (Handbuch der Zahnheilkunde^ 
Berlin, 1842) says that, although he has followed the preparative method 
indicated by Serres, he could never discover in the fetus the germs of 
all the teeth. Perhaps, he adds, the time when the development of the 
teeth begins varies considerably in individuals, just as we remark differ- 
ences in the time of eruption. 

In Chapter XVII of his book, Eustachius speaks of the process of 
formation of the teeth, which he studied in abortive fetuses, in stillborn 
children, in children a few months old, and also in kids. 

On dissecting a fetal jaw, there may be found on each side, as we have 
already seen, the incisors, the canines, and three molars, still soft and 
imperfect, separated from one another by very thin osseous partitions. 
Each of these teeth is enclosed within a follicle or little bag of a grayish 
white color, rather more mucous and glutinous than membranous, and 
in form somewhat like the pod of a vegetable, with the only difference 
that it shows an opening at one of the extremities, from which the tooth 
somewhat protrudes, as if it were germinating. The more recent and 
softer the tooth, the more its follicle has a mucous appearance and differs 
from the nature of membranes. As it does not adhere to the under- 
lying tooth, it is easy to separate them. As to the tooth, it is at that 
period of its development partly osseous and partly mucous, since that 
part which later on projects from the gum soon becomes transformed 
into a white thin and concave scale, which gives the idea of one of the 
little cells of a honeycomb. This scale is harder and more conspicuous 
in the incisors, since these, at this stage, are better formed; the canines 
are less advanced in development, and the molars still less; and among 
these latter, those are less developed which are more distant from the 
canines. The deeper part of the tooth consists of a mucous and tenacious 
substance, harder, however, than the substance of the follicle, and of a 
whitish color with a tendency to dark red, translucent, and somewhat 

Thus, says Eustachius, the teeth present themselves in a human fetus; 
but he who cannot obtain a human fetus may observe the same things 
in a kid. 

Although the author does not express himself very explicitly, he seems 
to consider the follicle of the tooth substantially identical with its liga- 
ment. "This is at first mucous, but afterward, becoming more consistent, 


causes the tooth to adhere to the socket and gum very firmly, as if it were 

" As the part of the tooth which comes out of the gum projects from 
the aperture of the follicle like a gem from its bezel, so — says Eustachius 
— some believe that the crown of a temporary tooth is a mere appendix, 
and that the follicle comes out of its concavity through a dividing line 
which they imagine to exist between this supposed appendix and the 
remaining part of the tooth. But assuredly those who assert such things 
show that they have studied the anatomy of the teeth so carelessly that, 
by this one error, they make manifest their great ignorance together with 
their great temerity/ The line which is observed on the tooth on the 
part corresponding to the adhesion of the gingival margin and of the dental 
ligament is very superficial, and after having scraped it away, there does 
not remain any trace of a division. But apart from this everyone can 
very easily observe, even in infants, or in kids, that the tooth when ossified 
does not present any line of division and that the still mucous follicle 
envelops it freely, and may be easily separated from the tooth; which 
would not be the case, if the follicle issued from between the tooth and 
its supposed appendix." 

Thus, Eustachius declares entirely false the opinion already expressed 
by Celsus, that the permanent tooth grows from the root of the milk tooth. 
He affirms clearly and decisively that between the external and the radical 
part of a milk tooth no real division exists, and that the ossification of the 
tooth, beginning from the crown, proceeds without any interruption right 
down to the end of the root. If it were true, says he, that in children only 
the imaginary epiphysis or appendix falls, and that the new tooth is sub- 
stantially represented by the remaining part of the first, it could never 
happen, as instead it often does, that the new tooth appears before the 
first one falls. Besides, between the lower part of the first tooth and the 
upper part of the second no correspondence exists either in size or shape, 
as ought necessarily to be the case if the two parts were joined together. 
This is not all; the lower part of the temporary tooth is perforated, and 
receives in its interior bloodvessels and nerves, whilst the upper part of 
the permanent tooth is quite massive and imperforated. How, then, 
could this second tooth transmit bloodvessels and nerves into the cavity 
of the first? Again, how could the continuity of these bloodvessels 
and nerves with their respective branches be possible, if an imperforate 
body, such as the crown of the permanent tooth, were really interposed ? 

But what is the use of so many arguments .? exclaimed Eustachius. 

* This sharp reproof and accusation of ignorance are made for the benefit of the immortal 
anatomist Andreas Vesalius, to the number of whose adversaries Eustachius likewise 
belonged. What unjust fury of party passion! 


To remove even the slightest doubt and to put an end to any controversy 
on such a point, only one fact is sufficient, which is revealed to us by 
anatomical dissection, and that is, that the teeth which appear about the 
seventh year are not only not united to those which fall at the same 
period, but cannot even be in contact with them, owing to the presence of 
a thin osseous partition. 

In the following chapter^ Eustachius speaks of the central cavity of 
the teeth and of the substance contained in it. In young teeth, he says, 
the dental cavity is very large, in proportion to the size of the tooth. 
According to some anatomists, the central cavity of a tooth is coated by 
a very soft and thin membrane, formed by a tissue of very small vessels 
and nerves; and besides, this cavity is filled with marrow, like hollow 
bones. The observations of the author, however, do not agree with these 
statements. The dental cavity does not contain any fatty substance 
analogous to the marrow of bones. As to the above-mentioned mem- 
brane, Eustachius doubts its existence. The large hollow existing in 
children's teeth contains, he says, a mucous substance, somewhat hard, 
and very smooth at its surface — almost like a cuticle — but which has rather 
the appearance of a concretion than of a membranous tissue. At any 
rate, adds Eustachius, if the substance alluded to is made to dry up in the 
shade, it acquires an appearance not unlike that of a membrane. It 
is certain, however, that at an early age the substance contained in the 
dental cavity does not adhere to the walls of the latter after the manner 
of a periosteum, but is found in simple contact with the same, and can, 
therefore, be separated from them with the greatest ease. 

As years pass by, the dental cavity becomes narrower and narrower, 
because the substance contained inside the tooth gradually becomes 
ossified at the surface, adhering to the dental scale previously formed, in 
the very same manner as the internal or woody part of a tree adheres 
to the bark. Of the two hard substances which make up a tooth, the 
outer one is white, tense, and dense, like marble, the underlying one, 
instead, is somewhat dark, rough, and less compact. To observe accu- 
rately the above-mentioned facts, the author advises searching for them, 
first, in the molar teeth of the ox or the ram, and then in human teeth, 
and likewise, first in children or in recently born animals, and then in 

Chapters XIX and XX are, comparatively speaking, of little impor- 
tance. In the former the author undertakes especially to examine the 
opinions of Galen on dental bloodvessels and nerves, and discusses whether 
it were known to him that these vessels and nerves penetrate into the 
internal part of the teeth. In the latter, Eustachius speaks of the great 

' Chap. \v'\\\, p. 54. 


difficulties that are encountered in dissecting dental bloodvessels and 
nerves, and reproves those who, by inaccurate illustrative figures, convey 
the erroneous idea that these parts are very clearly and easily observable. 

In Chapter XXI the author goes on to speak of the best mode of 
proceeding in order to make successful observation of the small nerves 
and vessels going to the roots of the teeth. These researches are much 
more easily made in large animals than in man; and therefore such things 
as cannot be observed well in the latter must be studied in the former. 

In the first place, it is necessary to dissect the lower jaw; and after 
having done so several times, with all the accuracy required in making 
researches of this kind, one may proceed to study the dental nerves and 
vessels of the upper jaw, which is much more difficult. Having opened 
up the inside of the lower jaw, one observes a cavity full of marrow, and 
within this a nerve enclosed entirely in its own sheath. Having removed 
the marrow, and opened the sheath lengthwise, one perceives that the 
nerve therein enclosed is constituted (analogous to what may be observed 
in the large nerves of the limbs) by several nervous strings, and that among 
these runs a comparatively large artery, besides small vascular branches 
of minor importance. If one then removes the sheath from the bone, 
together with the nerve and the vessels contained in it, raising it very 
gently, one sees, issuing therefrom, some very slender fibers, on the nature 
of which it is, however, difficult to pronounce; and, considering their 
thinness, one can hardly conceive that they are composed of three different 
elements, that is, of small nervous, arterial, and venous twigs. At any 
rate, the author admits that this may be so. On arriving at the lesser 
teeth, the nerve and the artery that accompanies it divide into two branches, 
one of which traverses the opening presented by the bone at that point 
(mental foramen)^ and is destined to the lower lip; the other directs its 
course toward the roots of the incisors. The small twigs which penetrate 
into the roots of the incisor and canine teeth are less slender than those 
which enter the roots of the molars, and are easily to be seen not only in 
large animals, but also in man. If the tooth of an ox or that of a ram 
be split through the middle, the mucous substance contained in the 
interior is seen to be traversed by small bloodvessels; and one perceives, 
besides, certain fibers, which are probably nerves. All these things, says 
Eustachius, I have observed many times in different animals, in some 
cases more, in others less distinctly. But it is an exceedingly difficult 
thing to follow the single twigs, of which we have spoken, from their 
origin to their insertion, or, vice versQy from their insertion to their origin. 
And so, adds the great anatomist, being able to observe but a small 
part of the things I should like to see, I find myself compelled, in my 
perplexity, to supply by the aid of ratiocination the deficiency of the 
senses. I therefore maintain that the interior part of a tooth is susceptible 


of experiencing pain accompanied by a feeling of pulsation (a fact already 
mentioned by Galen), because a nerve and an artery penetrate into it. 
In the ox the penetration of bloodvessels into the roots of the teeth can 
be more readily ascertained than in man. It may be admitted that the 
same occurs in the human teeth; and this, for the reasons already given, 
and also because only by admitting the existence of an artery within the 
cavity of the tooth can be explained the copious flow of florid red blood 
from a decayed tooth, which has, in some cases, been known to imperil 
the life of a patient. And I myself, says Eustachius, have observed 
with my own eyes an accident of this kind. 

The author then passes on to speak of the eruption of the teeth, ^ but 
the data with which he furnishes us are neither very precise nor very 

Eustachius, without declaring himself for or against it, cites, in this 
chapter, the opinion of those who believe in the possibility of a third 
dentition in old people. He returns to this subject in the last chapter 
but one of his book, which treats of dental anomalies: " Ali," says he, 
"testifies to old persons having had all their teeth renewed. This has 
been derided as chimerical by medical men of later date, or at least only 
admitted under the condition that such teeth be of a nature completely 
diff^erent from the first/' 

Our teeth, says the author, grow old together with us, and toward 
the term of life they abandon us, a fact which also distinguishes them 
from the other bones. When, however, it occurs, through illness, that 
the teeth are extracted or fall out spontaneously before the period of 
old age, the alveoli become filled up with a bony substance; and in addi- 
tion the two osseous scales of the maxillary bones approach one another 
and unite together in such a manner as to form a sharp margin, every 
vestige of a cavity being obliterated. 

Speaking of the nutrition and growth of the teeth,^ Eustachius says 
that — ^given the existence of the dental nerves and bloodvessels — it is 
not difficult to explain how the teeth are nourished, grow, live, and feel. 
He therefore rejects the opinion of those who held that the teeth of the 
lower jaw derived their nourishment from the marrow contained within 
this bone, and that those of the upper jaw received it from a humorous 
substance similar to marrow, existing in the large cavity of the upper 
maxillary bone. Against the supporters of this opinion Eustachius 
raises, among others, the following objections, viz., that the marrow of 
the inferior jaw does not in any way touch the teeth, so that such a mode 
of nourishment cannot be imagined, and that it is completely erroneous 
that the large cavity of the upper maxillary bone contains a humor 

' Chap, xxii, p. 65. ' Chap, xxiii, p. 70. 


similar to marrow. This passage of Eustachius' book gives clear evidence 
that he was well acquainted with the maxillary sinus, described a century 
later by the English anatomist, Highmore, who gave it his name. The 
existence of this cavity was, besides, already known before the time of 

The author also says that those who believe that the internal cavity of 
the teeth contains marrow, and that this serves to nourish them, are 
grossly deceived. 

In the same chapter, Eustachius confutes an opinion, at that time gener- 
ally diffused and put forward for the first time by Aristotle, viz., that 
the teeth grow throughout a whole lifetime. In the senile age, he says, 
the teeth become impaired still earlier than the other organs. They 
become thinner by deficiency of nourishment, and, at the same time, 
discolored; the incisors and canines, as they waste away, come to be also 
less sharp than they were; and the molars, losing their tubercles or cups, 
become levelled down and smooth. If, notwithstanding the evident 
wearing out of the teeth, they seem sometimes to grow longer, this appear- 
ance is not to be trusted, for it happens not unfrequently that the teeth 
appear to have grown longer simply by atrophy of the gums, or also 
because some humor or other morbid substance pushes them outward. 

As to the sensibility of the teeth,* Eustachius is of the opinion that these 
organs possess, besides the sensibility to pain, two other species of sensi- 
bility; for, following the ideas of Galen, he also holds that the teeth 
together with the tongue partake in the sense of taste; and he further 
considers the disagreeable sensation known as setting on edge of the teethy 
as a species of tactile sensation peculiar to these organs. 

But in which part of the tooth does the faculty of feeling reside ? 

Among the authors previous to, or contemporaries of, Eustachius, 
some affirmed that the sensibility of the tooth resides in the pellicle which 
lines its inside cavity, others in the membrane which, like periosteum, 
clothes the root of the tooth, others in both these parts. Eustachius 
does not show himself more partial to the one than the other of these 
opinions; he is, however, firmly persuaded that the hard substance of the 
tooth is also endowed with sensibility. Though it is not easy to explain 
how this may be, he considers it probable that the nerve, fraying 
itself out inside of the tooth in minute filaments at the time when the 
substance of the tooih is still soft and mucous, intermixes intimately 
with it, thus communicating to it the faculty of feeling, which then per- 
sists in it, even after the ossification of the tooth. Such an hypothesis is 
certainly worthy of the lofty intellect of Eustachius, and has in itself, so 
it seems to me, something of truth. 

* Chap. XXV, xxvi. 


In the two following chapters/ the author speaks in a masterly and 
admirable manner of the functions of the teeth and of their utility. 

Among many other true and interesting observations, he remarks that 
by the loss of their teeth even the most powerful dogs become cowards. 

Besides what concerns the human teeth, excellent notions of compara- 
tive anatomy, above all in what regards the monkey, the dog, and the rumi- 
nants, are to be found in this little but most precious book of Eustachius. 

The teeth, says he, are not equally hard in all animals, and many 
ancient authors have affirmed that ferocious animals have much harder 
teeth than tame ones. 

Chapter XXIX, relating to dental anomalies, is one of the most inter- 
esting. We here quote the greater part of it. 

"Some historians relate that Pyrrhus, King of Epirus, Eurifeus, of 
Greece, and many others, had, instead of teeth, a continuous bone, fur- 
rowed by somewhat. deep vertical lines, in no way different from what 
one sees in the multiple molars of the goat. It has never happened 
to me, says Eustachius, to witness a similar union of all the teeth; I 
have, however, sometimes observed continuity between three or four 
molars, precisely in the same manner as in sheep. It also once happened 
to me to observe in the case of an old man, a fellow citizen of mine, that 
the teeth were covered up on every side by a hard and almost stony sub- 
stance, and no longer exhibited any trace of separation, offering instead 
the appearance of a single bone." 

"One reads that Timarchus, of Cyprus, had two rows or series of teeth 
and Hercules three." 

The author never had any opportunity of observing any such anomalies; 
notwithstanding, he refers to cases of the kind observed by other anato- 
mists of his time, and, in a particular manner, to the case of a triple dental 
series in a youth who died at the age of eighteen. As the truth of the 
fact was testified to by highly respectable medical men, Eustachius lends 
faith thereto. "Neither can it be said" — he adds — "that in the case 
we are speaking of the new teeth erupted from other sockets before the 
temporary ones were shed, for there would then have been only a double 
and not a triple series; indeed, the series would not even have been double 
along all the line, but only along the line of the temporary teeth; and 
besides this, the double series would not have been maintained up to 
eighteen years of age — the time of the death of the subject — but only until 
the shedding of the deciduous teeth." 

"That teeth are sometimes cut in the palate is a fact attested to by 
Alessandro de Benedetti and others. It has also occurred, within my own 
experience, to observe this in the person of a Roman woman, who had a 

' Chap, xxviiy xxviii. 


tooth in the roof of the mouth, near the opening which is in proximity 
to the incisor^/ and at Gubbio there is, in the monastery of the Trinita, 
a nephew of the distinguished jurisconsult Girolamo Gabrielli, who at 
the age of eighteen cut a tooth in the middle of the palate." 

"Pliny and Solinus tell of individuals born with all their teeth. Other 
authors, that Pheretes was without teeth all his life." 

" I hold it to be a fable that some women lose a tooth for each child 
they bear." 

"In some cases it has happened that the falling out and renewal of 
the teeth has not taken place before the age of thirteen or fourteen. 
In other cases, the same teeth were shed and renewed twice, that is, once 
after the seventh year, and again after the fourteenth year. It ought 
also to be mentioned that in some young persons of twenty, the last molar, 
or wisdom tooth, having been drawn, it was renewed during the same 
year. Lastly, it is also to be noted that in strong and healthy young per- 
sons, one of the other molars being extracted, it is sometimes renewed."^ 

In the last chapter* the author alludes to some dental affections. In 
referring to the fluxions to which teeth are subject, he says he has observed 
more than one case in which such a quantity of matter resembling chalk 
was collected in the alveoli, that these gradually being filled thereby, all 
the teeth became loosened and dropped out little by little. 

Speaking of dental diseases requiring surgical intervention, the author 
remarks that dental surgery was, in his days, a most abject calling, not- 
withstanding its having had, according to Cicero, a very high initiator — 
^sculapius, the god of medicine. 

Ambroise Pare. Whilst the anatomy of the dental system was illus- 
trated by the researches of Fallopius and Eustachius, the celebrated 
French surgeon Ambroise Pare was contributing in the highest degree to 
the progress of practical dentistry. 

Ambroise Pare (Latinized Paraeus) was born at Bourg-Hersent in the 
year 1517. His father and one of his brothers were box-makers; another 
brother was a barber. We have no very precise information about the 
early years of his life; so much is certain, however, that Ambroise Pare 

' The inferior orifice of the foramen incisivum. 

^ It is superfluous to say that these cases are unreal and simply dependent upon erroneous 
observations; for instance, in the case of the second molar being extracted before the erupting 
of the third, the second molar figured as, and supposed to be, the latter, when, finally, the 
wisdom tooth appeared, it was believed to be the last molar renewed. It is no rare thing, 
also, in these days, not only for unprofessional persons, but also for medical practitioners, 
to fall into errors of this kind, especially because, in similar cases, the wisdom tooth, having 
but a limited space in which to erupt, is in the habit of filling the void left by the second 
molar, where it meets with less resistance. 

^ Page 93. 



did not enjoy any of those advantages deriving from a good literary educa- 
tion, and after having received some instruction from a chaplain, whose 
disciple and servant he was at one and the same time, he was bound 
over as apprentice to a barber, who also taught him the art of bleeding. 
Toward the age of sixteen we find him in Paris in the employ of a 
chirurgien-harhier. After this he practised minor surgery for some years 
in the Hotel-Dieu. But having undertaken the study of surgery without 
literary preparation and without any knowledge of Latin, he was obliged, 
especially for the latter reason, to contend with great difficulties, so that, 
although he had acquired in a few years sufficient practice in surgery to 
enable him to pass from the Hotel-Dieu to the sanitary service of the 
French army, it was only in 1554, that is, at thirty-seven years of age, 
that he was permitted to take the examination required for becoming 
a member of the College of Surgeons of Paris. Within the short space 
of five months he was successively named Bachelor, Licentiate, and 
Doctor in Surgery. His reputation, which had already become extraor- 
dinary even before he had any academic degree, procured him introduc- 
tion to the Court of France as surgeon in ordinary. In 1562 he became 
chief surgeon to the Court and occupied this post under the reigns of 
Charles IX and Henri III. Ambroise Pare was a Protestant, and it 
is said that in the massacre of St. Bartholomew's night, he owed his 
escape to the king, Charles IX, who, to save his life, hid him in his ward- 
robe. He died full of honors, in the year 1592. 

In his works this great surgeon treats the subject of dental maladies 
and their cure very thoroughly; this may be in part attributed to the cir- 
cumstance of his having first been simply a barber (and, therefore, also a 
tooth-puller) and afterward a surgeon-barber, which placed him in very 
favorable conditions for acquiring vast experience in the practice of 

In Chapter II, Book IV, of his works,^ Ambroise Pare speaks of the 
anatomy and physiology of the teeth. It must, however, be confessed 
that Vesalius and, still more so, Eustachius treat of dental anatomy with 
much more exactness than he does. 

After having spoken of the incisors and the canines, he says that the 
ten upper molars generally have three roots, and very often four, whilst 
the ten lower ones have only three; this is because the lower jaw is harder 
than the upper, and also because the lower molars, estant assises sur la 
raciney et non suspenduesy comme celles de la mandibule d^en hauty navotent 
besoin de tant de racines pour leur stabilite asseurance? 

^ CEuvres completes d'Ambroise Pare, accompagnees de notes historiques et critiques, par 
J. F. Malgaigne, Paris, 1840, vol. i, p. 231. 

* The lower molars, being seated on the roots and not suspended like those of the upper 
jaw, are not in want of so many roots to assure their stability. 


Ambroise Pare, too, admits that the teeth grow throughout the whole 
lifetime, and that the wearing away consequent on reciprocal friction and 
mastication is compensated in this way. 

Galen had already affirmed, and Ambroise Pare also held erroneously, 
that the exquisite sensibility of the teeth aids the sense of taste. 

In speaking of the development of the teeth, Ambroise Pare says only 
that they are already solid and osseous before birth, he himself having 
observed this in dissecting the jaws of a child who had died immediately 
after birth. 

In Chapter VII, Book XIII, ^ Pare treats of fracture of the lower jaw. 
The method of cure he proposes is altogether identical with that of Celsus. 
With regard to the teeth, he says that "j/ elles sont diviseesy ehranleesy 
ou separees hors de leurs alveoles ou petites cavitesy elles dotvent estre 
reduites en leurs places et seront liees et attache es contre celles qui sont 
fermeSy avecques un fil d^or ou d'argenty ou de lin, Et les y faut tenir 
jusques a ce qu^ elles soient bien affermiesy et le callus soient refait et rendu 

Toothache, says Pare,^ is, of all others, the most atrocious pain that 
can torment a man without being followed by death. It depends, in 
many cases, on a humorous fluxion of a hot or cold nature which flows 
into the alveolus, forcing the tooth outward, loosening it, and causing 
the patient so much pain on the slightest pressure being exercised on it, 
that he cannot dare to bite with it in the least. If, however, the tooth 
is corroded, hollowed out, or pierced to the root, the pain is so strong, 
when the patient drinks — particularly if the liquid is cold — ^that he seems 
to have had a stab with a stiletto inside the tooth. 

If the pain is acute and pungent, like that produced by needles being 
thrust into the diseased tooth; if the patient complains of a strong pulsa- 
tion at the root of the tooth, and in the temples; if the application of cold 
remedies calms the pain, all these signs indicate that the cause of the evil 
is heat. Instead, the cause of the pain may be held to be cold when the 
patient complains of a great heaviness in the head, emits a quantity of 
saliva, and finds relief in the application of hot remedies. In the treat- 
ment of toothache one must fulfil the following three indications: 

1 . Regulate fittingly the mode of living. 

2. Evacuate or dissipate the morbid humors; this may be effected 
by various means, namely, by purgatives, by bleeding, by gingival 

* Vol. ii, p. 307. 

^ . . . if they are divided, shaken, or separated from their alveoli or little cavities, they 
must be reduced into their places and should be bound and fastened against those that are 
firm with a thread of gold, silver, or flax. And they must be held thus until they are quite 
Rrm and the callus is formed and have become solid. 

^ Lib. XV, ch. xvi, vol. ii, p. 443. 


scarification^ by the application of leeches on the site of the pain, by 
cupping on the back of the neck, or on the shoulders. 

3. Applying in each single case the medicaments best adapted for 
calming the pain. 

The author here goes through a long enumeration of anti-odontalgic 
remedies that offer no particular interest, as they are not at all new. 

When a decayed tooth becomes the seat of excessive pain, and this 
does not yield to any remedy, one must either have recourse to extraction 
or cauterize it; this can be done either with potential caustics — such as 
oil of vitriol, aqua fortis — or with the actual cautery. By cauterizing, 
Pare adds, one burns the nerve, thus rendering it incapable of again feeling 
or causing pain. 

Erosion or caries* is the effect of an acute and acrid humor, that corrodes 
and perforates the teeth, often to their very roots. To combat this 
morbid condition, even when it is not accompanied by pain, one must 
also have recourse (besides general treatment) to cauterization either 
with oil of vitriol, with aqua fortis, or with a small actual cautery. 

If, as often happens, that the seat of the erosion lies in such a manner 
between two teeth as to make it impossible to apply caustics or other 
medicaments, one must file just sufficiently between the healthy and the 
corroded tooth to render the part accessible, taking care, however, to file 
more on the side of the affected tooth than on that of the healthy one. 

The file may be used, besides, to plane down a tooth that stands out 
above the level of the others, and for similar purposes. 

If one or more teeth have been shaken by a blow or a fall, or have come 
out of their alveoli altogether, the surgeon should not remove them, but 
rather reduce them and bind to the neighboring teeth, that they may 
entirely reacquire their original firmness. 

In allusion to this subject, Ambroise Pare refers to the case of a friend 
of his, who having sustained, through a blow from the hilt of a dagger, 
a fracture of the lower jaw with almost complete expulsion of three 
teeth from their alveoli, had the fracture reduced by him; after replacing 
the teeth and binding them to the neighboring ones, he prescribed astrin- 
gent mouth washes and liquid or semiliquid nourishment, such as meat 
juice, panada, barley soup, jelly, and such like. The patient was com- 
pletely cured and able to masticate with the three teeth as well as before. 

Also in the case of extraction of a healthy instead of a diseased tooth, 
Pare recommends replacing it immediately and binding it to the neighbor- 
ing ones, for, he says, by this means the tooth can take root again. 

As we have seen, the first author who speaks of replantation is Abulcasis, 
but to Ambroise Pare belongs the merit of having treated the subject 

* Lib. XV, cap. xxvii, vol. ii, p. 448. 



much more explicity, and of having insisted on the utility of this opera- 
tion, indeed, on the duty of carrying it out whenever it seems indicated. 
Further, he is the first to mention another very important operation, 
namely, transplantation, albeit he himself had never performed it. The 
case he refers to has become a generally known anecdote. We give it in 

Fig. 6o 


Dental files (Ambroise Pare). 

his own words: "f/n homme digne d^estre creu ma affirme qu^une prin- 
cesse ayant fait arracher une denty s*en fit remettre subit une autre d'une 
sienne demoiselle^ laquelle se reprinty et quelque temps apres maschoit 
dessus comme sus celle qu^elle avoit fait arracher auparavant^^ 

* A man, worthy of being believed, has assured me that a certain princess having had a 
tooth taken out, immediately had it replaced by another supplied by one of her ladies, which 
took root, and after a time she masticated writh it as well as she had done with the former 



Ambroise Pare has recourse to extraction when a tooth is the cause of 
very violent pain, or when the existence of a carious cavity and concomi- 
tant putrefying processes render the breath fetid, and endanger the healthy 

Fig. 6i 

One or the pelicans used by Ambroise Pare. 
Fig. 62 

teeth in its vicinity. If the persistence of a deciduous tooth should cause 
the cutting of the corresponding permanent tooth outside the line of the 
dental arch, thus giving rise to deformity, Pare advises laying bare and 


then extracting the deciduous tooth; for after this the new tooth may be 
pressed toward the point before occupied by the other, until it assumes its 
natural position. 

Sometimes, when a tooth is too firmly planted, one prefers, says Pare, 
instead of extracting it, to break off the crown for the purpose of being 
able to act directly on the dental nerve with appropriate remedies, or 
to destroy the sensibility of the nerve entirely, by cauterization. This 
unreasonable and reprehensible method of cure is also quoted, under 
the denomination of deschapellementy by another French author, a con- 
temporary of Pare — Urbain Hemard — ^who observes, however, that one 
rarely had recourse to it; for the pain and shock which are caused by this 
operation are not less than those caused by extraction. 

It very often happens that the patient cannot indicate exactly which 
tooth it is that gives him pain, his sufferings being so acute as to appear 
spread over a great part of the jaw. One cannot, therefore, trust too 
much to the indications given by the patient as to the point of departure 
of the pain, and must take care not to extract a healthy instead of a 
diseased tooth. 

The extraction of a tooth should not be carried out with too much vio- 
lence, as one risks producing luxation of the jaw or concussion of the 
brain and the eyes, or even bringing away a portion of the jaw together 
with the tooth (the author himself has observed this in several cases), 
not to speak of other serious accidents which may supervene, as, for 
example, fever, apostema, abundant hemorrhage, and even death. 

In extracting a tooth it is necessary to place the patient on a very low 
seat, or even on the ground, with his head between the legs of the operator.* 
After having laid the tooth bare sufficiently, if one sees that it is very 
loose, one may push it out of its socket with a poussoity that is, with a 
trifid lever. But if the tooth is too firmly rooted to be extracted with this 
instrument, one must make use of curved pincers, or else one may have 
recourse to a pelican. The author notes, however, that much skill is 
required in using this latter instrument, for otherwise it will almost cer- 
tainly happen that several good teeth will be knocked out, instead of the 
one intended to be extracted. In proof of this, he relates the following 
anecdote, which we relate in the words of the author, that it may not 
lose anything of its quaint originality: 

**Je veux icy reciter une histoire d'un maistre barbier, demeurani a 
Orleans, nomme maistre Fran9ois Loiiis, lequel avoit par dessus tous, 
rhonneur de bien arracher une dent, de fa^on que tous les samedis 
plusieurs paysans ayans mal aux dents venoient vers luy pour les faire 
arracher, ce qu'il faisait fort dextrement avec un polican, et lorsqu'il 

* Lib. XV, cap. xxviii. 



avoit fait, le jettoit sus un ais en sa boutique. Or avoit-il un serviteur 
nouveau, Picard, grand et fort, qui desiroit tirer les dents a la mode de 
son maistre. Arriva cependant que ledit Francois Louys disnoit, un 
villageois, requerant qu'on luy arrachait une dent, ce Picard print Tinstru- 
ment de son maistre et s'essaya faire comme luy; mais en lieu d'oster la 
mauvaise dent au pauvre villageois, luy en poussa et arracha trois bonnes. 

Fig. 63 


Two gum lancets and a trifid lever called "poussoir" (Ambroise Pare). 

Et sentant une douleur extreme, et voyont trois dents hors de sa bouche, 
commen^a a crier contre le Picard; lequel pour le faire taire luy dit 
qu'il ne dist mot, et qu'il ne criast si haut, attendu que si le maistre venoit 
il luy feroit payer les trois dent pour une. Done le maistre oyant tel 
bruit, sortit hors de table pour s^avoir la cause et raison de leur noise et 
contestation; mais le pauvre paysan redoutant les menaces du Picard, 
et encore apres avoir endure telle douleur qu'on ne luy fist payer triple- 


ment la peine dudit Picard, se teut, n'osant declarer audit maistre ce 
beau chef d'oeuvre; et ainsi le pauvre badaud de village s'en alia quitte; 
et pour une dent qu'il pensoit faire arracher, en remporta trois en sa 
bourse, et celle qui luy causoit le mal en sa bouche.'*^ Pare adds in con- 
clusion: " Partant je conseille a ceux qui voudront faire arracher les dents, 
qu'ils aillent aux vieux dentateurs, et non aux jeunes qui n'auront encore 
reconneu leurs fautes."^ 

But let us now return to our subject. After the extraction of a tooth, 
it is necessary — says Pare — to leave the wound to bleed freely, so that 
the part may get rid of the morbid humors; then the gums and the 
alveolus must be pressed, on both sides, with the fingers, to readjust the 
socket, which will have been widened and sometimes even broken in 
extracting the tooth. After this, the patient should rinse his mouth 
with oxycrate; and when the weather is cold and windy, the patient 
should take care to avoid fluxion in the other teeth. 

The following chapter speaks *^Je la limosite ou rouillure des dents ^ 
et de la maniere de les conserver,*^ 

After meals the mouth must be rinsed with water and wine, or with 
water with a little vinegar added to it, and the teeth cleaned from all 
residues of food, so that their putrefying may not spoil the teeth and make 
the breath fetid. An earthy yellowish substance, like rust, often forms 
on the teeth from want of cleanliness and also when they are not used to 
masticate; this substance corrodes the teeth, just as rust corrodes iron. 
It is necessary to remove this substance, by scraping the teeth with small 
instruments suitable for the purpose, and then the teeth themselves must 

* I will here tell a story of a master barber living at Orleans, named maistre Francois 
Louys, who had the honor of pulling a tooth better than any one else, so that on Saturdays 
many country folks having toothache came to him to have them pulled out, which he did 
very dexterously with a pelican, and when he had done, threw it on a bench in his shop. 
Now he had a new servant, Picard, tall and strong, who wanted to pull teeth like his master. 
It happened that whilst the said Fran9ois Louys was dining, a villager wanting a tooth 
pulled, Picard took his master's instrument and tried to do like him, but instead of taking 
out the bad tooth, he knocked and tore out three good ones for him, who, feeling great 
pain and seeing three teeth out of his mouth, began to cry out against Picard, but he, to make 
him hold his peace, told him not to say a word about it and not to shout so, because if his 
master came he would make him pay for three teeth instead of one. Now the master, hearing 
such a noise, came out from table to know the cause of it and the reason of the quarrel, 
but the poor peasant fearing the threats of Picard and still more after enduring such pain 
being made to pay a threefold fee by the said Picard, was silent, not daring to reveal to the 
master this fine piece of work of the said Picard; and thus the poor bumpkin went away, 
and for one tooth that he had thought to have pulled, he carried away three in his pouch 
and the one that hurt him in his mouth." 

^ For which reason I advise those who would have their teeth pulled to go to the older 
tooth-pullers, and not to the younger ones who will not yet have recognized their short- 



be rubbed with a little aqua fortis and aqua vitae mixed together, to take 
away what the instruments have not been able to remove. In order to 
preserve the teeth it is necessary, besides, to rub the teeth frequently 
with appropriate dentifrices. Among these the author mentions simple 
bread crust, burnt and reduced to powder. 

In Chapter III of Book XVII he speaks of artificial teeth. Sometimes, 
says Pare, by the effect of a blow, the front teeth are lost; this not only 
constitutes a deformity, but is also the cause of defects of speech. There- 
fore, after the necessary treatment, when the gums are hardened, the 
lost teeth must be substituted with artificial ones made out of bone, 
ivory, or the teeth of the Roharty^ which are excellent for this purpose; 
and the artificial teeth must be tied to the neighboring ones with gold or 
silver wire. 

Chapter IV of the same book is most important, for palatal obturators 
are therein spoken of for the first time. " Sometimes a portion of the 
bone of the palate is destroyed by the shot of an arquebus, or by some 

Fig. 64 

The palatine obturator with sponge of Ambroise Pare. 

Other wound or by a syphilitic ulcer {par ulcere de verole)y the patients 
being thereby disabled from properly pronouncing words and from 
making themselves understood. To repair this defect we have found an 
expedient through the help and ministry of our art. It consists in the 
application of an instrument somewhat larger than the palatal perfora- 
tion; this is made of gold or silver, of about the thickness of a crown (coin), 
and has the form of a vaulted roof, to which a sponge is attached; when 
introduced into the aperture, the sponge, absorbing the humidity natural 
to such parts, will very soon swell up, and thus the instrument is held firm. 
In this way, words are better pronounced." 

Besides the above instrument, the author gives us the figure of another 
instrument, sans esponge (without sponge), which, taken altogether, 
is like a large cufF button. The small part, designed to be introduced 

' An old French word meaning perhaps hippopotamus. 


into the aperture of the palate, can be made to turn round from below, 
by means of a small pair of pincers, so as to fix the obturator. 

In the last chapter of Book XVIII, first dentition and the treatment 
required during this period are spoken of. The cutting of teeth, says 
Pare, is accompanied by pain, itching, and pricking of the gums; often, 
as well by diarrhea, fever, epileptic convulsions, which sometimes end 
fatally. The symptoms by which it may be known that teeth are about 
to come forth are as follows: The wet-nurse feels the mouth of the 
suckling infant to be hotter than usual; the gums are swollen; the child 
is restless, crying often and sleeping but little; it emits a quantity of 
saliva from the mouth, and frequently puts its fingers in its mouth, trying 
to rub its gums, and soothe, in this way, the pain and itching which it 
feels. It is then necessary to treat the nurse as if she had fever, and the 
infant should be suckled less than usual; some cooling and thirst quench- 
ing drinks should be given to it — for a child in such conditions suffers 
from intense thirst; the nurse should often rub the gums of the little patient 
with softening and soothing substances, as, for example, oil of sweet 

Fig. 65 

Fare's palatine obturator without sponge. 

almonds, fresh butter, honey, or mucilage made from the seeds of the 
fleawort or of the quince; the brains of a hare (these may be roasted or 
boiled) have not only a very soothing action, but also, according to a very 
ancient belief shared by Pare, possess the occult property of aiding the 
cutting of the teeth. But oftentimes, neither these nor other remedies 
are of any use, because the gums are too hard and the teeth cannot cut 
their way through at all; the tension of the gums then produces very violent 
pain, fever, and other accidents, death even supervening in some cases. 
The author, therefore, advises lancing the gums deeply, just above the 
tooth which ought to appear, thus opening it a way, that it may more 
easily come out. He relates that he has performed this operation on his 
own children in the presence of many medical authorities. 

Almost as if to show the high value of this operative procedure. Pare 
tells the case of a child, the son of the Duke of Nevers, who died at the age 
of about eight months without having cut any teeth. He, together with 
other doctors, was invited to carry out an autopsy. No lesion whatever 
was found sufficient to cause death, but the gums were very hard, thick, 


and swollen; an incision into them showed that the teeth were ready to 
come out, if only their eruption had been facilitated by lancing at the 
right time. Pare and the other doctors were of the unanimous opinion 
that death was caused solely by the impossibility of cutting the teeth on 
account of the hardness of the gums. 

Among the many strange cases given in Book XIX (Des monstres et 
proJiges)y Pare also speaks — ^trusting to the word of Alexander Benedetti 
— of the case of a woman, who, after the complete loss of her teeth caused 
by age, cut them all again at eighty years of age. 

Although Pare treats so amply and with such competence all that 
concerns dental diseases and their cure, he does not make the least 
allusion to the stopping of teeth, beyond recommending, as had aready 
been done by Celsus, that when a tooth that is to be extracted shows a 
large cavity, the latter should be well filled with linen or lead, so that the 
tooth be not fractured under the pressure of the instrument and so leave 
the root behind in the alveolus. 

A century before Ambroise Pare, Giovanni d'Arcoli had already 
mentioned the filling of teeth with gold leaf, and, as we have seen already, 
there is very good reason to believe that the practice of this operation 
dated back to a still earlier period. How is it, then, that the illustrious 
French surgeon does not say a word about this ? Very probably stoppings 
were not at all in use among French dentateurs and perhaps, even in 
Italy, this operation was only rarely carried out. 

Jacques Houllier (1498 to 1562), a celebrated French physician and 
surgeon, also known under the Latinized name of Jacobus HoUerius, 
was the first to stand out, although timidly, against the theory of dental 
worms. He did not decidedly deny their existence, this having been 
affirmed by so many illustrious writers; he, however, speaks of them 
as if the point were a doubtful one: "/^ is said that worms are generated 
in the teeth, which corrode the teeth themselves, and produce a pain which 
is not very violent and causes itching with little or no salivation {vermes 
ajunt subnasci dentibus^ et hos corrodere^ a quibus dolor nan ita fortisj 
pruriginosusj nulla aut pauca salivatio),** 

But even while putting in doubt the existence of dental worms, he be- 
lieves it his duty to enumerate the various remedies, recommended for 
their destruction. As to fumigations with the seeds of the hyoscyamus, 
Houllier, declares that what is believed by the common people, and what 
has been written by doctors of antiquity about worms being killed and 
seen to fall from the teeth by the effect of these fumigations, is all nonsense. 
In fact, he says, when the seeds of the hyoscyamus are burnt there fly 
away from them what appear to be little worms, even if the fumes do not 
reach the worm-eaten tooth. (Qt^od autem vulgus sibi persuadety et 
ab antiquis medicis scriptum est de suffumigio e semine hyoscyamiy videtur 


fabulosum. Nam inde ajunt manifeste vermes exciJere. Re verOy incenso 
semtney evolant tanqua vermiculiy etiam si non attingit fumus vermiculo- 
sum Jentem.) 

Apart from this, in the works of Houllier, nothing is found that is of 
interest for the history of dentistry. He repeats several errors and 
prejudices of the ancients; he says, for example, that men have ordinarily 
thirty-two teeth, women, twenty-eight; and he, too, believes in the ex- 
pulsive virtues of the fat of green frogs when applied to a tooth {adeps 
ranee viridis dent em de pell it). 

Houllier does not contribute in any way to dental therapeutics, he only 
enumerates the methods of cure recommended by preceding authors/ 

VoLCHERUS CoiTER (1534 to 1600), of Groningen, an ardent student of 
anatomy, and a pupil of Fallopius, Eustachius, and Aranzio, studied 
with great attention the development of bones, dissecting many fetuses and 
children of various ages for that purpose. He clearly states his opinion 
that the teeth are not bones, since they do not pass, like the latter, through 
the cartilaginous stage, but are derived instead from a mucous substance.^ 

JoHANN Jacob Wecker, a doctor of Colmar, published in 1576 a 
valuable medical work composed of synoptical tables, in which is briefly 
summarized the best of what had been written by preceding Greek, 
Latin, and Arabic authors. 

One gathers from this author that at the time in which he wrote it 
was considered an excellent preservative against the plague to rub the 
teeth with theriac, mithridate, angelica, and zedoary. From this it may 
be perceived that even in those days doctors had understood the impor- 
tance of the cleanliness and disinfection of the mouth as a prophylactic 
against infective diseases. 

In the above-mentioned bo.ok may be found a sufficiently complete 
exposition of dental therapeutics of that and of the preceding periods. 
There is nothing, however, which is not already known to us from our 
examination of the earlier writers. Worthy of notice is the information 
that, among other things, to facilitate the cutting of teeth rubbing the 
jaws with turpentine was recommended at that time.' 

DoNATO Antonio of Altomare, a Neapolitan physician and philos- 
opher, dedicated a long chapter of his Ars medica* to the subject of 
dental pains and their treatment. He classifies these pains with great 

* Jacobi Hollerii medici parisiensis omnia opera practica, Genevae, 1635, ^^^* "> P- ^'7» 
et seq. 

^ Blandin, Anatomic du systeme dentaire, Paris, 1836, p. 25. 

^ Hoann Jac. Weckerus, medicinae utriusque syntaxes, ex Graecorum, Latinorum, 
Arabumque thesauris collectse, Basilea, 1576. 

* Donati Antonii ab Altomari medici ac philosophi neapolitani Ars Medica, Venetiis, 
1558, cap. xli, p. 190. 


accuracy, taking into account their seat and causes, and pointing out in 
each single case the method of cure to be followed according to the warm, 
cold, dry, or humid nature of the pain. In what he says, however, we 
do not find anything new. 

GiULio Cesare Aranzio (1530 to 1589), a celebrated surgeon and 
anatomist of Bologna, in which city he taught from the age of twenty- 
six years until his death, is of the opinion that parulides — that is to say, 
inflammations or abscesses of the gums — and epulides — that is fleshy 
excrescences of the same — are usually caused by caries or putrescence 
of the teeth; but that in certain individuals, from a peculiar weakness 
of the gums, these are easily attacked by inflammation when the wind is 
in the south. 

In the case of parulides, to soothe the pain and to accelerate the 
suppurative process, emollient substances should be used; afterward it 
is necessary to open the abscess with a lancet, to wash the mouth with 
mulse, and to aid the process of cicatrization by using syrup of roses. 

As to epulides, these must be made to disappear, by sprinkling the 
tumor with the powder of gall-nuts, or by moistening them frequently 
with a decoction of gall-nuts, or with sulphur water. But if they do not 
yield to these remedies, and are the cause of functional disturbances, 
the surest and most prudent method of cure would be the use of the 
red-hot iron. 

Giovanni Andrea Della Croce, a celebrated Venetian physician 
and surgeon, was the author of a most valuable treatise on surgery, which 
was published first in Latin (Chirurgice universalis opus ahsolutuniy 
Venetitiis, 1573), and then in Italian under the title of Chirurgia 
universale e perfetta^ Venezia, 1583. According to this author, dental 
fistulae are more common to the lower jaw than to the upper one. To 
cure these fistulae, it is necessary to extract the diseased teeth from which 
they originate, even should they ache but Httle or not at all. To confirm 
this, he relates in full a very interesting case of a dental fistula, that he 
cured by the extraction of a tooth which hardly ached at all. 

Flajani* chose to see in this case a precocious example of the opening 
of Highmore's antrum through the alveolus. But the description given 
by Andrea della Croce of his case does not at all warrant this supposi- 

At the end of his book Andrea della Croce gives us the figures of many 
dental instruments, which have, however, nothing new about them. 

Gerolamo Capivacci, of Padua, repeats the advice (already given by 
preceding authors) to avoid, in eating and drinking, the rapid changes 
from heat to cold, and vice versa^ since, says he, nature does not tolerate 

' Collezione d'osservazioni e riflessioni, vol. iii, oss. 84, p. 374. 


these rough changes.^ In the mercurial treatment of syphilis,' he recom- 
mends the patient, as soon as the action of the remedy manifests itself 
in the oral cavity, to keep a piece of gold in his mouth, that the mercury, 
on account of its particular affinity, may unite with the gold and the harm- 
ful effects of this strange remedy on the mouth may be thus avoided. 
A strange method of curing mercurial stomatitis! 

JoHANN ScHENCK VON Grafenberg (1530 to 1598), a Celebrated 
doctor of Freyburg-in-Breisgau, has left us, in his Observation's medicaj 
a very rich and interesting collection of clinical cases. In this work he 
refers to many observations upon dental diseases by earlier authors, which, 
however, have already been noted by us in their time and place. Among 
other things, Schenck von Grafenberg relates that Cardanus was able, 
more than twenty times, to calm a violent toothache which tormented 
him by lightly pressing the sick tooth between the thumb and index 
finger of his left hand. 

Peter Foreest (1522 to 1597), a very famous Dutch doctor of Alkmaar, 
repeats the very old error — already in decisive terms denied by Andreas 
Vesalius — ^that women have only twenty-eight teeth, whilst men usually 
have thirty-two. To the two central incisors he gives the name of colu^ 
mellares. Sugar and all sweet things, says this author, are very harmful 
to the teeth, and he gives as a proof the fact that apothecaries have, in 
general, very bad teeth, on account of the frequency with which they 
taste syrups and the like. Perhaps things are now changed, since I 
am not aware that chemists in our days are to be distinguished by the 
bad state of their teeth ! 

In regard to toothache, Foreest records an important observation which 
he had made on himself; an aching tooth which a surgeon had not suc- 
ceeded in extracting, but which was simply loosened, ceased, without 
anything else being done, from giving him pain, and in a short while 
became firm again, and he continued to use this tooth for about five years. 
However, on a renewal of the pain he was obliged at last to have it ex- 
tracted. On the strength of this observation, the author believes that 
in certain appropriate cases, recourse may be had to the luxation of a 
tooth, rather than to its extraction to obtain a cessation of toothache. 

This method of cure had already been advised by a still earlier writer, 
that is, by Avicenna. When a subluxation produces the rupture of the 
dental nerve, this, in its results is equivalent to a replantation. 

Foreest is the first to speak of the violent inflammation of the gums 
and of the whole mouth, caused by the application of artificial teeth of 
ivory fixed in their place with gold wire. This cannot at all astonish 

* Hieronymi Capivacci Patavini opera omnia, Venetiis, 1617, edit, sexta, lib. i, cap. 
liii; de afFectibus dentium, p. 515. 

* Lib. ii, cap. v, de lue venerea, p. 712. 


us when we consider how imperfectly, in those days, dental prosthesis 
was carried out and how the immobility of the artificial pieces, caused 
them to be a source of permanent irritation to the neighboring parts, 
especially on account of the difficulty met with in giving proper care to 
cleanliness. He, therefore, entirely rejects the application of artificial 
teeth. He is likewise but little inclined to the use of the pelican, it being 
very easy to break the teeth with it, and, instead, he recommends the use, 
whenever it be possible, of another instrument which he calls pes bovinus, 

Foreest relates several cases of dental fistulae which he had cured by 
the extraction of the faulty teeth. In one of these cases, observed in 
a lady, the fistula had opened between the nose and the cheek, so that 
a malady of the upper jaw was feared (and, in fact, as William Sprengel 
observes, it is not improbable that this was a case of affection of High- 
more's antrum); he obtained a complete cure in a short time by the extrac- 
tion of -a diseased tooth. 

According to Peter Foreest, the existence of dental worms is as certain 
as is that of intestinal, auricular, and other worms. Even on the pre- 
tended efficacy of remedies, capable of making the teeth fall out without 
pain, he does not throw the slightest doubt. 

Foreest attributes to his master, Benedictus of Faenza, the merit of 
having introduced into therapeutics the trephining of teeth for the cure 
of certain violent pains not accompanied by any external lesion of the 
tooth. We know, however, that the invention of this operation dates 
back to Archigenes. Benedictus trephined the tooth with a very fine 
drill {stylo vel terebello subtilissimo) and then filled it with theriac, using, 
likewise, as occasion required, other remedies. 

To demonstrate the propriety and the necessity of laying bare the neck 
of the tooth before extracting it, he relates a case in which fracture of 
the jaw was the result of having neglected this precaution. 

Among the sundry causes of the looseness of teeth, he mentions the 
softening of the dental nerve {emollitio)^ but this erroneous opinion had 
already been expressed by Galen. 

As a means of cleaning teeth and keeping them free from tartar, he 
advises, among other things, the use of pumice-stone powder. He dis- 
approves, however, of the use of oil of vitriol — unless in very minute 
quantities of, at the very most, one or two drops.* 

Urbain Hemard, a surgeon to the Cardinal d'Armagnac, published 
in 1582, at Lyons, a booklet entitled: Recherche de la vraye anathomie 
des dentSy nature et proprietez d^icelleSy oil est amplement discouru de ce 
quelles ont plus que les autres os; avecque les maladies qui leur adviennenty 
et les remedies. This is the first dental monograph that appeared in 
France. The pamphlet is written with much erudition, but its contents 

^ Petri Foresti, Alcmariani, opera omnia quatuor tomis digesta, Rothomagi, 1653. 



are almost entirely taken from preceding authors. Hemard indicates 
by the term deschapellement (decrowning) the removal of the crown of a 
tooth for curative purposes. He speaks of this operation as of a method 
but recently introduced into therapeutics; but, and very reasonably, too, 
he shows himself somewhat hostile to such a method of cure. 

As to what concerns the anatomy of the teeth, Hemard's book does not 
contain anything original. The following passage, transcribed by Portal/ 
shows luminously that Urbain Hemard, instead of making researches of 
his own, has simply copied the Italian Eustachius, translating the latter 
almost literally. The beauty of it is that Portal had not noticed the 
plagiarism in the least, since he says that if Urbain Hemard had taken 
into account the researches of Fallopius and Eustachius as well, his book 
would have acquired still greater value. But, in truth, he has taken into 
account, and has valued the researches of Eustachius so much as to palm 
them off as his own ! We here quote, side by side, with a paragraph taken 
from Hemard's book, the corresponding passage of Eustachius, that our 
readers may be convinced of the truth of what we have stated: 


. . . apcrta utraque maxilla occurrunt 
incisores, canini, ac tres molares, nimirum 
secundus, tertius et quartus; partim mucosi, 
partim ossci, non obscuras magnitudinis, 
suisque prsesepiolis undique vallati: 

incisoribus autem et caninis docta manu 
detractis, tenuissimum interstitium vix 
osseum factum conspicitur; quo pari dili- 
gentia amoto, obviam veniunt totidem 
incisores et canini pene mucosi et longe 
minores, qui post alios priores in propriis 
caveis latentes, singuli singulis c regione 
oppositi collocati essent, nisi utriusque 
maxillx caninus magna ex parte proximo 
incisori incumberet, eumque propterea fere 

Primorum molarium et genuinorum qui 
circa septennium ac longe etiam postea ori- 
untur, fateor me nullum vestigium vidisse. 


. . . leur ayant ouverte Tune et Tautre 
machoire, j'y ai trouve seulement les dents 
incisoyres, les canines, et les trois mache- 
lieres de chaque couste de machoire; a 
s9avoir la seconde, la troysieme et la qua- 
trieme, lesquelles estoit partie osseuses 
parti mucillagineuseSyde mediocre grandeur, 
garnies a Tentour de leurs petits estuis 
ou alveoles. Et depuis ayant tirees dehors 
lesdictes dents incisives et canines, il se 
trouve un entre-deux osseux; lequel ayant 
pareillement oste, il se presente de dessoubs 
autant de dents incisives et canines, toutes 
presque mucillagineuses, representant la 
substance d*un blanc d'ocuf a demy cuite 
moindres pourtant que les precedentes 
estant cachees dans les mesmes estuits 
aprcs les premieres. 

Quant est des premieres machelieres 
et des gemeles qui a sept ans, ou long- 
temps apres commencent a sortir, je con- 
fesse n*en avoir trouve jamais aucune 
trace n*v commencement. 

^ Histoire de Tanatomie et de la chirurgie, Paris, 1770. 

^ Hemard has omitted translating this passage, probably because he did not well under* 
stand \x. 



Verisimile tamen est, rationique consen- Toutesfois, il est vraysemblable et raison- 

taneum, eos perinde ac secundos incisores able aussi,qu'ellesayent prisdanslamatrice, 

et caninos rude quoddam, sed minus perspi- lout ainsi que les inctsoyres el canines 

cuum initium oitus in utero sumere; secondes, quelque petit commencement de 

sensimque postea similiter formari el absolvi naysance et forme, moins apparante toute- 
fois, mais qui depuis se fafonne el parfaict 

At the time when Urbain Hemard was publishing his pamphlet in 
France, several other monographs were already appearing in various 
parts of Europe on teeth and their atFections. A few years after Ryff 
had initiated dental literature in Germany, other odontological writings 
were published in Spain and in Italy. 


copcdiofo. Sobrc la materia d la dc 

tadiira, ymarauillofaobradlabo 

ca.Co mochosrcmedios y aui 

{<x necciTarios.Yla orde 

dc curar>yadrc{ar 

lot dientes . 

f Dirigido>al muy altoy muy pode 
lofofciionel Principe d6 Carlos nrofc- 
iior.Co|)ue(1o por el Bnchiller Fricifco 
Marti nez.Nitural dcia villa dc Caltrillo 
dc ontc]o.EftSt< en Valtadolid. ifsj* 
Con preuilegie. 
cEfla tafikdo en 1^ V U. Bii^ 

page of Francisco Martinez's book (Valladolid, 1557). 



Francisco Martinez/ in 1557, gave to the press in Valladolid a 
Coloquio breve y compendioso sobre la materia de la dentadura y maravillosa 
obra de la boca^ con muchos remedios y avisos necessariosj y la orden de 
curar y adre^ar los dientes. 

Fig. 67 

Four of the instruments represented in Francisco Martinez's book. 

Fig. 68 

A dental excavator used for ascertaining which one among several decayed teeth 

was the one causing the pain (F. Martinez). 

Fig. 69 

pm«r^W l »,^V,; ,'<mt.llil.AAtTT?? 

^.\k« ««\X\^>« \ *\N%\ M\« VV^ \W^\%«« \« .%> \«\ • 


A chisel and a mallet for separating teeth (F. Martinez). 

Fig. 70 

A pelican (F. Martinez). 

*[For a fuller review of this author see A Dental Book of the Sixteenth Centuiy, by 
Julio Endelman, Dental Cosmos, 1903, vol. xlv, p. 39. — E. C. K.] 



In the same year and city was printed a Latin pamphlet, De dentioney 
by Franciscus Martinus de Castrillo, probably the author of the pre- 
ceding book. In 1563 was published in Venice the excellent treatise 
of Eustachius on the anatomy of the teeth {Libellus de dentibus). At 
Frankfort was published, in 1576, the second dental monograph in the 
German language, Zahnarzneyy by Adam Bodenstein von Carlstad; 
and two years later Petrus Monavius published in Basle a Latin pamphlet 
on dental diseases {De dentium affectibus). 

Fig. 71 

Fig. 72 

Different kinds of forceps (F. Martinez). 

The above-mentioned works, apart from the book of Eustachius, which 
is, of its kind, a real masterpiece, have but little importance. We have 
cited them here solely to show in what years and in what countries the 
very first dental monographs appeared. 

GiROLAMO Fabrizio, of Aquapendente (1537 to 1619), a celebrated 
anatomist and surgeon, wrote some very valuable works, among which 
a treatise on surgery, in which the part relative to the affections of the 
dental system is treated briefly but with great orderliness and clearness, 
thus giving a very precise idea of what dental surgery was at the end of 
the sixteenth century. 



The principal operations which it is necessary to perform on teeth are, 
he says, seven in number/ viz. : | aJ 

I. Forced opening of the dental arches in cases of prolonged constric- 
tion of the same, so as to prevent the patient from dying of hunger. 

Fig. 73 

^ l^yT. ^>i^'?»-^^VA.^VR■v:cs7^. ;^t^k^v■ ; ^ ■,vy.>^ 

^?j::i^^5S:^r >^ 


Instruments for removing deposits from the teeth (F. Martinez). 

Fig. 74 

A dental scraper. 


A universal toothpick and a file for sharpening its points. 

An instrument for removing sharp corners from the molar teeth (F. Martinez), 

2. Cleaning of the teeth. 

3. Medication of carious cavities. 

4. Filling with gold-leaf. 

5. Removal or resection of teeth abnormally situated. 

6. Removal of any unevenness or sharpness of the teeth. 

7. Extraction. 

* Hieronymi Fabricii ab Aquapendente opera chirurgica, Lugduni Batavorum, '7^3» 
cap. xxxii, p. 451. 


In regard to the first operation, the author first of all examines the 
various causes of the constriction of the dental arches, and according to 
the various nature of this, he indicates in what cases it is fitting to have 
recourse to the forced opening of the jaws by means of appropriate dilators, 
and in what cases it is best to avoid it. In the latter case one must 
seek to feed the patient in other ways — that is, either by alimentary 

Fo. t$% 

Virgo martircgre^ 

pronobis Apolonia; 
ntnde pr^cti ad dominll 

ne pro ream cruninO: 
Vcxcmur inorbo d£ci& 

A figure representing St. Apoitonia, reproduced froin the tin page of F. ManJnez's book. 

clysters, or by a little tube passed through a space already existing or 
purposely made by the extraction of one or two teeth ; or else by letting 
a cannula reach down to the pharynx, through the nose, or, lastly, by 
introducing a cannula into the oral cavity through the free space existing 
behind the last molars. But in regard to this last method, Fabricius 
notes that if the constriction is of a spasmodic nature, the spasm may 
affect not only the elevator muscles of the jaws, but also those that govern 


deglutition, including sometimes even those of the tongue itself, and in 
this case, as the food introduced into the oral cavity could not be swallowed, 
it is preferable to convey it directly into the pharynx, by means of a cannula 
passed through the nostrils. 

The second of the above-mentioned operations^ is designed, says 
Fabricius, to take away the dirtiness of the teeth and the bad odor of the 
mouth {dentium imrnunditiam et oris foetorem tollii). The dental tartar 
(pstracodermd) must be removed by slender instruments of an appropriate 
shape, which, for people of high position {promagnatibus) shall be made 
of silver. This advice is sufficient to make us understand that Fabricius, 
although an excellent surgeon, had no practice in dental operations; 
otherwise he would have known that the hardness and adhesion of tartar 
is generally so great that its removal absolutely requires scrapers of 
tempered steel and not of a soft metal like silver. 

To arrest caries, he first drops into the carious hollow, by means of a 
small silver funnel, some drops of oil of vitriol, or of some other caustic 
liquid; and then he performs actual cauterization with appropriate instru- 
ments; after which the cavity is filled with gold leaf (auro foliato). 

When one or more teeth have appeared in an irregular position and 
offend the walls of the oral cavity or else the tongue, the excision (resec- 
tion) of the tooth or teeth must be performed with a pair of strong pincers, 
whose shape must vary according to whether the teeth are situated ex- 
ternally or internally with regard to the dental arches. But as after the 
resection there will almost always remain some points or sharp irregular- 
ities, which by their presence would continue to irritate the soft parts, it 
will be necessary to remove these irritating prominences by means of 
the file. 

As to extraction, Fabricius of Aquapendente counsels great prudence 
in performing the operation, and on this point he repeats all the warnings 
already given by Celsus, an author whom he greatly admires and the 
study of whose writings he warmly recommends. 

It seems that in those times there was more than sufficient reason to 
inculcate extreme caution in regard to the extraction of teeth. This 
was not then performed by true dentists, but rather by barbers and by 
ignorant tooth pullers, or else, in exceptional cases, by general surgeons, 
very skilful, perhaps, in everything else, but little practised in the opera- 
tion we are speaking of; besides this, the instruments left much to be 
desired; and lastly there was not, nor could there be, any idea of asepsis. 
What wonder, therefore, if the extraction of teeth was frequently the cause 
of serious injuries! Fabricius relates that it often happened to him to 
have to extract, in little fragments, half or sometimes a whole jaw, which 

* Cap. xxxiii, p. 455. 


had been attacked by putrefaction, as the result of the extraction of one 
single tooth. This, adds the author, may easily happen, because, when 
the jaw is attacked by pus in one point, its very anatomical constitution 
favors the rapid spreading of the putrefying process to the other parts of 
the bone, as this latter, apart from its external lamina, is entirely com- 
posed of a sponge-like substance. 

The instruments which are used for the extraction of teeth, are, says 
Fabricius, of nine kinds ;^ and the most important among them — gen- 
erically called forceps — are indicated by special names, taken from their 
resemblance to the mouth or beak of certain animals. Thus, the forceps 
with which it is usual to perform the extraction of molar teeth are called 
"pelicans," and of these there are two kinds, according as they are used 
for the right or the left side, for the upper molars or the lower ones. 

A third kind of instrument goes under the name of **beak** (rostrum), 
and serves for the extraction of the incisors. 

A fourth kind is the "crow's beak," or "crow's bill," which is used 
for the extraction of roots. 

Two other instruments are named in Italian "cagnoli," for they imitate 
the strong bite of the dog (in Italian cane) and are used in cases where 
the pelican is not adapted. 

A seventh instrument is called by the Latin term of terebra (drill or 
auger). It is used instead of a lever to separate the teeth from one another 
when they are too close to each other, and so render their extraction 
much easier. 

The eighth instrument is a "trifid lever" (vectis trifidus)^ so called 
because it is furnished with three points. 

The ninth and last kind of instruments are the dentiscalpiay slender, 
sharp, and oblong tools, with which the gums are separated from the 
teeth before extraction. 

Fabricius also speaks of dental prosthesis, but very briefly. He says 
that artificial teeth are made of ivory or of bone (for example, from the 
tibia of the ox) and are fastened by gold wire. One has recourse to this 
means especially to correct the bad appearance and the defects in speech 
deriving from the loss of the front teeth. 

This author also makes some allusion to palatal obturators,^ but in 
very general terms, limiting himself to saying that when a perforation 
exists in the hard palate, it may be corrected by a piece of sponge or 
cotton, or with a plate of silver fixed in the palate, so as to close up the 
aperture (corrigitur spongiay vel gossypioy vel lamina argentea^ qua palato 
appendatur^ ut foramen obstruat), 

' Cap. xxxiv, p. 456; de instrumentis extrahendts dentibus idoneis, 
' Cap. XXXV, p. 457. 


For epulides and parulides Fabricius advises the same methods of cure 
that had been recommended by Paul of ^gina. 

In the case of flaccidity of the gums accompanied by looseness of the 
teeth, the treatment must consist, first of all, in superficial cauterization 
with the red-hot iron, after which the gums must be smeared with honey, 
the mouth washed with mulse, and lastly astringent powders must be 

If the gums are much swollen, in near relation to the molar teeth, the 
use of the red-hot iron, says Fabricius, becomes very difficult from the 
want of space, and from the close vicinity of the healthy parts, which 
must not be injured. In such a case, it is necessary to remove, with suit- 
able cutting instruments, as much as is possible of the morbid tissue 
(^caro crass a et putriJa); then to cauterize the remaining part, making 
the cautery, if necessary, pass through a tube, so as not to injure the 
surrounding parts. When, however, the gingival swelling bleeds very 
easily, and its excision thus might give rise to a profuse hemorrhage, 
it will be best to perform the operation with cutting instruments heated 

Fabricius remarks that although other authors do not make any allu- 
sion to these large gingival excrescences, he had had occasion to observe 
several cases, and had also had various instruments especially constructed 
for their cure.^ 

JoHANN Heurn, or in Latin Heurnius (1543 to 1601), of Utrecht, in 
his book on the diseases of the eyes, ears, nose, teeth, and mouth, treats 
sufficiently at length of dental diseases and their cure, but without adding 
anything of importance to what had been written by preceding authors. 
His work is a mere compilation, which would be without any importance 
whatever if it did not serve to show what credit was still given at that 
period to all the errors and prejudices which are to be found in the 
writings of the ancients. 

Heurnius, although he wrote a long time after Vesalius, still adheres, 
in regard to the number of teeth, to the already mentioned opinion of 
Aristotle; he says, in fact, that women rarely have thirty-two teeth like 

He warns those who suffer from odontalgia not to have recourse thought- 
lessly to tooth drawers, but to recur, instead, to the doctor, who will always 
treat the affection according to the cause on which it depends. 

And here the author repeats the numerous distinctions found in many 
preceding writers, and especially in Arculanus. The pain may be located 

* Cap. XXX, de gingivarum chirurgia, p. 450. 

^ Joannis Heumii Ultrajectini de morbis oculorum, aurum, nasi, dentium et oris, liber 
Raphelengii, 1602, cap. xi, de dentium et oris passionibus, p. 79. 



in the gums, in the dental nerve, or in the very substance of the tooth; 
and in each of these cases it may depend on warm or cold matter, on 
dryness, humidity, etc. 

The method of treatment must vary in all these cases; and in regard to 
this the author enters into minute particulars, commencing with dietetic 
cure — which itself must be varied according to the causes of the affection — 

Fti;, 76 

A D. 

Van L.vdcn, 

and then treats of all the other therapeutic means — purgatives, blood- 
letting, revulsives, local narcotic or resolvent medicaments, and so fonh. 
The letting of blood was, it seems, a very favorite method of cure; not 
onlv were the veins of the arm opened, but also those of the tongue, 
of the gums, of the lips, and of the ears! 

Another remedy which the author seems to have a predilection for is 
oil of vitriol. When a tooth shows a carious perforation, he applies 


inside it, by means of a split feather, a drop ot oil ot TkrioL wiiiclu says 
he« causes the fall of the tooth after a few days. 

Fllsewhere he says that ** sometimes worms are produced in carious teeth; 
to kill them a drop of oil of vitriol is an excellent remedy; and this at die 
same time cures the decay of the tooth and takes away die sensibility of 
the nerve/' 

This passage does not agree ver\' well with die preceding one, according 
to which oil of vitriol would act much more radicaUy by causing die tooth 
to fall out altogether. But we wfll not take exception to so smaU a matt^; 
so much the more, as the author, if he were still alive, might perhaps show 
us by some subtle distinction that the contradiction alluded to is ordy an 
apparent one! 

To free the teeth from tanar, Heum likewise counsels oil of \-itriol, 
diluted, however, with other liquids. 

A tooth must not be sacrificed excepting when it is loose and attacked 
by incipient necrosis, so as to leave no hope of arresting the putrefactive 
process. It is then our duty, says Heum, to remove the tooth without 
causing much pain. For this purpose, after the tooth has been separated 
all around from the gums, it must be raised somewhat from the alveolus; 
then it must be sprinkled with powder of euphorbia, or a paste made with 
flour and the juice of the tithymalus must be applied around it, taking 
care, however, to cover the neighboring teeth ^4th wax. After two or 
three days the tooth will be so loose that it can be pulled out very easily 
with the fingers or with a pair of pincers. 

Dental surgery properly so called has been entirely neglected by 
Heurn. He was perhaps so persuaded of the efficacy of the above- 
mentioned remedies as to believe that every other species of intervention 
was useless. On the contrary, he does not abstain from speaking very 
seriously of the miraculous virtues of certain remedies (serpent scales, 
dog's teeth, etc.); and tells us, among other things, that the broth made 
from a frog, when held for a length of time in the mouth, soothes dental 
pains, whatever be the causes from which they originate. One would 
seem to have gone back again to the days of Pliny! 


In I59^{ a rumor spread throughout Germany of a great marvel that 
had appeared at Schweidnitz in Silesia: a golden tooth had erupted in 
the mouth of a child aged seven years, which, more precisely designated, 
was the first large molar on the left of the lower jaw. 

In our (lays news of such a kind would be immediately qualified, 
and universally held to be an imposture. But three centuries ago the 


most marvellous and unlikely things were easily believed in, often even 
by the learned; and, therefore, the fact alluded to was taken into serious 
consideration, so much so that for a long time many learned pamphlets 
and dissertations were written concerning it. 

Jacob Horst, Physician and Professor of Medicine at the Julius 
University in Helmstadt, published, in 1595, a very singular book on the 
golden tooth of the Silesian child. ^ Without raising any doubt as to the 
reality of the fact, he maintained that the phenomenon was produced 
from the effect partly of natural and partly of supernatural causes, in 
relation with the constellation under which the child was born. On the 
day of its birth, that is, December 22, 1585, the sun was in conjunc- 
tion with Saturn in the sign of Aries. In consequence of this circum- 
stance the nutritive force had developed marvellously on account of the 
increase in heat, and consequently, instead of osseous substance, golden 
matter had been secreted! 

After having explained (!) in this way the origin of the phenomenon, 
Horst passes on to examine what events may be portended by this un- 
heard-of marvel, he not having the least doubt that it — like earthquakes, 
eclipses, and comets — must be the precursory sign of important events. 
Supporting his assertions by arguments of various kinds, some of which are 
taken from the Bible, he concludes that the gold tooth of the Silesian child 
means neither more nor less than the approach of the golden age! The 
Roman Emperor would sweep the Turks, the enemies of Christianity, 
out of Europe, and the Millenium or Golden Age would commence. 
As the tooth was situated on the left side of the lower jaw, it might be 
deduced, according to Horst, that heavy calamities would precede the 
beginning of the epoch of happiness thus predicted. On the other 
hand, as the golden tooth was the last of the dental series of the child, 
this was to signify that the golden epoch thus foretold would be the last 
of the ages of this world before the universal judgment! 

Martin Ruland, in the same year, 1595, wrote about the gold tooth.' 
Shortly after, he was answered by Johann Ingolstetter; and the con- 
troversy which arose between them in this important subject lasted for 
a long time, without, however, leading to any definite conclusion. 

Balthasar Camindus, a doctor of Frankfort, meanwhile had noted 
that for some months the marvellous Silesian boy had not lent himself 
to being examined by the learned, becoming terribly enraged whenever 
they wished to compel him. From this he inferred that it was a case of 
nothing else but an imposture, and that the famous tooth could not have 

^ De aureo dente maxillari pueri Silesii, Lipsiar, 1595' 

' Martini Rulandi, Nova et in omni memoria inaudita histona de aureo dente, Franco- 
furti, 1595. 


anything special about it, save that its crown had been very skilfully 
covered with a thin plate of gold. 

In spite of this the discussions on the portentous tooth continued for 
a long time; and even one hundred years after, that is, in 1695, a new 
dissertation appeared on the golden tooth. 

The greater number of those who wrote on this subject did not throw 
the slightest doubt upon the reality of the fact, but only sought to explain 
in the most varied ways the genesis of this phenomenon. 

Duncan Liddel. Among those who had the good sense not to put 
faith in the thing, and who very decidedly affirmed that this was a mere 
case of imposture, Duncan Liddel, a Scotchman and professor in a German 
University, deserves to be recorded.^ 

He had heard that the famous gold tooth was larger than the others, 
and that the neighboring molar was wanting; from which he argued 
that this was simply the case of a tooth the crown of which had been 
covered with a plate of gold. Answering the arguments of Horst, he ac- 
cused him of gross ignorance in the most elementary notions of astronomy, 
and this for having affirmed that when the famous child was born, that is, 
December 22, the sun happened to be in conjunction with Saturn in the 
sign of the Ram. As the sun does not enter the sign of the Ram until 
March, if it had been there on December 22 this would have been a 
greater portent than if the whole body of the child had been formed of 
nothing else but teeth of gold P 

^ Liddelius, Tractatus de dente aureo pueri Silesiani, Hamburg, 1626. 

*[In the introductory portion of Liddell's work on the "Golden Tooth" is published a 
number of letters bearing on the case, among others one which gives rather a circum- 
stantial account of the imposture, and of which the following is a translation: 
Herr Balthazer Caminaeus sends Greeting: 

For your letter, most kind Herr Doctor Caselius, in which you explicitly desired me 
to thank (my) colleagues for their good wishes, * wedding wishes,* and to imform you as 
to the * Golden Tooth,' I have long been in debt to you — not that I intended to leave 
your letter unanswered, but because no messengers presented themselves. Now that I 
have found one, I announce that I have obeyed your commands. As for the * Golden 
Tooth,' I ought not to hide from you that we have more than once marvelled at your 
shrewdness, in that you are so anxious to ascribe the devices of wickedness and the tricks 
(fakes) of cunning to Nature. For it was no portent, only a deception and pure cheat, so 
that unless some Lemnian (Prometheus or Vulcan) should come to their aid, these acute 
authors will, nay, already are, a by-word to those who are more cautious and not so prone 
to believe. For the * Golden Toothed ' boy, according to the account brought thither by 
many persons, both by letter and oral report, some of whom had themselves seen this 
wonder, hailed from a village near Schwidnitz in Silesia, and had been so trained by his 
swindling father or master, that, at his will, whenever in any assembly of men, some very 
simple and illiterate persons desired to see the tooth and had paid the fee, for the rascals 
made great gains, he would open his mouth wide and allow himself to be touched. But 
if educated men and those who seemed likely to make more careful scrutiny and experi- 



The above-mentioned fact is not the only one of its kind. Serres 
relates that once there was a great noise made in Poland about the pre- 
tended golden teeth of another child who was carried round from city to 
city for the purpose of making money. A Franciscan monk had sought 
to explain, in one of his writings, the formation of these teeth. The 
anatomist Kircher answered him in a pamphlet which had the very 
suitable epigraph: O pneclare pateVy nimium ne crede colori,^ In fact, 
the pretended teeth were only covered with a layer of tartar of golden 
color. As the falsity of the pretended miracle might be brought to light 
at any moment with much scandal, a bishop thought it well to put an 
end in haste to the comedy, by ordering the removal of the deceitful layer 
of tartar from the teeth of the child, to be performed in public, so that the 
imposture might be made completely clear. 

From the above story we can, at any rate, deduce an important con- 
clusion for the history of dental art, that is to say, that even as early 
as 1593 there was an artificer (we do not know whether a goldsmith or 
dentist) who knew how to construct a gold crown, although only for the 
purposes of deception. 

ment on any point, presented themselves, he contorted his countenance, remained silent, 
and simulated a kind of madness, the idea being that he permitted himself to be examined 
at stated times only when the conditions allowed. Now, the tooth was covered with a 
plate, lamina (or layer), skilfully wrought of the best gold, and the gold was let down so 
-deep into the gum that the cheat was not observed. However, as the plate was sometimes 
rubbed with a touch-stone as a test and was daily worn down by chewing, the real tooth 
at last began to appear. Of this fact a certain nobleman got an inkling, came to the 
place pretty drunk, and demanded that the tooth should be shown him, when the young 
fellow, at his master's word, kept silent, the nobleman struck his dagger into the boy's 
mouth, wounding him so badly that the aid of a surgeon had to be called, and so the 
deception was fully exposed. 

" Thus the Herr Baron Fabianus, in Crema, at present Rector Magnificus of our Uni- 
versity, told me the story in full, and those inhabitants of the place who have scholarly 
tastes maintain it to a man. The author of the fraud, if I remember aright, was said to 
have taken refuge in flight, the boy to be in chains. 

" Our Pelargus, who is a native of Schwidnitz, can inform you more fully. I have 
often heard from him the same facts which I am writing. Farewell, and laugh in safety 
as much as you please at those sagacious authors. 

"Frankfort, December 31, 1595." 

Klsewhere it is stated that the boy who was the possessor of the " Golden Tooth " 
was born December 22, 1586. As Horst's Treatise appeared in 1595, the Silesian boy 
was probably not over seven or eight years of age. We also find that the " Golden 
Tooth " was a lower molar, and upon the left side, and further, that there was no molar 
posterior to it. — E. C. K.] 

' Illustrious Father, do not believe too much in the color. — [Virgil, Ec. ii, 16.] 


The first signs of the separation of dental science from general medicine 
were to be perceived in the sixteenth century, the period in which, as we 
have seen, the earliest dental monographs appeared. From that time 
this separation tended to accentuate itself ever more strongly; dental 
monographs became more numerous and dentistry progressed ever 
more rapidly, both in its scientific and practical aspects. 

In the seventeenth century, about which we are now to speak, we 
shall have to call attention to many facts of the highest importance for 
the development of dentistry, and with regard to literature, it is worthy 
of note that while the publications on dentistry that appeared in the 
various countries of Europe during the preceding century only amounted 
to about twenty (taking also into account several pamphlets on the 
famous golden tooth!), in the seventeenth century the number was con- 
siderably higher, that is, about a hundred. We shall speak of the most 
important of these, as also of the works on general medicine or on surgery 
of the same period, that present some interest from the point of view of 

JoHANN Stephan Strobelberger, physician to the imperial baths 
of Carlsbad, published in the year 1630 a very curious book, the title of 
which, being translated, runs somewhat as follows: Complete Treatise 
of Gout in the teethy or^ more properly saidy of Odontagra or toothache; 
tn which are setforth^ theoretically and practically^for the use of physicians 
and surgeons y the means of mitigating these pains y as well as the various 
modes of ably extracting teeth with or without instruments, ^^^ 

This book merely presents some interest, because it gives us a clear 
idea of the pitiful state in which the dental art still was in the first half 
of the seventeenth century, and shows us most clearly what enormous 
progress our specialty has made in little less than two centuries. Apart 
from this, Strobelberger's monograph is of no importance, it being 

* Joh. Stephani Strobelbergeri, thermiatri caesarei emeriti, etc., de dentium podagre, seu 
potius de odontagra, doloreve dentium, tractatus absolutissimus, in quo, tam doloris istius 
mitigandi rationes, quam dentium sine et cum ferro artificiose extrahendorum vani modi, 
theoretice ac practice proponuntur, in medicorum ac chirurgorum quorumvis gratiam. 
Lepsiar, 1630. 


nothing more than a most accurate compilation of all that is to be found 
on the subject of dental affections in earlier works, especially from the 
medical point of view; the surgical part of dental therapeutics is treated 
in a much less complete manner, and prosthesis is entirely excluded from 
the plan of the work, which, however, is fully in accordance with the title 
of the book. 

Under the generic name of gout,^ or podagra, are meant, says the 
author (Chapter I), all the affections produced by diseased humors, 
falling "by drops" into the articular cavities and the parts surrouuding 
them. Strictly speaking, however, only gout in the feet is named podagroy 
whilst when the disease is seated in other parts of the body it is indicated 
by other names, gout in the hands being called chiragra; in the fingers 
dactilagra; in the knee, gonagra; in the elbow, pechiagra; in the shoulder, 
omagra; in the spinal column, rachisagroy and so on. When the seat of 
the evil is in the teeth or in their articulations, by analogy it is denominated 
odontagra, or odontalgia, an affection which Paul of ^gina was the 
first to consider as being of a gouty nature (Chapter II). 

After having spoken of the sensibility of the teeth (Chapter III), of tah 
various kinds of dental pains (Chapter IV), of the different causes, external 
and internal, which produce them (Chapters V to VII), of the signs which 
make known their special nature in each case (Chapters VIII to X), 
and of the prognosis (Chapter XI), the author occupies himself very 
minutely, throughout the rest of the book, with all that concerns means 
of cure, dedicating to this subject sixty-seven chapters and a long appendix. 

If, after the publication of Strobelberger's book, all previous works 
treating of dental affections had been entirely lost, it would be of inesti- 
mable value for the history of dentistry, the author having gathered 
together in an almost complete manner — citing faithfully the respective 
authors — all that had been written about dental diseases before him. 
On the other hand, the book contains almost nothing original; therefore, 
rather than analyze minutely its contents — which would involve a long 
repetition of things already noted — we limit ourselves merely to a few 

Strobelberger, like Heurnius, is of opinion that for the cure of dental 
pains it is necessary to have recourse to doctors rather than to denttspicesy 
or tooth drawers (Chapter XII); however, he does not consider the calling 
of the latter absolutely useless; indeed, he expressly advises (page 174) 
that they should be applied to for the instrumental extraction of the teeth, 
it not being possible for such operations to be carried out well and with- 
out danger except by those who, through great practice, have acquired 
the necessary skill in the use of the relative instruments. He refers to 

* In Latin, gutta, that is, drop. 


the words of Hollerius, already quoted, as to the falseness of the opinion 
that fumigations made with the seeds of hyoscyamus cause the worms to 
fall out of the teeth. Notwithstanding, he does not in the least doubt the 
existence of the worms themselves; and he, like Heurnius, recommends 
killing them with oil of vitriol or with a decoction made from a frog cooked 
in water and vinegar (Chapter XXXIII). From this, one clearly per- 
ceives that the doubts expressed by Hollerius about the existence of dental 
worms had not in the least shaken the popular belief in them. Nor, 
indeed, could it be otherwise when one considers that Hollerius, as we 
duly noted in another place, had not the courage either decidedly to deny 
the existence of dental worms, or to formulate in a clear and explicit 
manner the doubts which had arisen in his mind on this subject. We 
are, therefore, unable to recognize the merit which Linderer^ and Geist- 
Jacobi^ have attributed to this author, viz., that of having effectually 
affirmed the non-existence of dental worms. 

Among innumerable vegetable remedies recommended by Strobel- 
berger against odontalgia, we will only cite two American plants, the 
guaiacum and the tobacco-plant (Nicotiana tabacum). Of the decoction 
of guaiacum (Chapter XXXVI) the author says that, used as a mouth 
wash, it has the triple virtue of strengthening the gums, of preventing 
putrefactive processes, and of calming toothache. 

The anti-odontalgic virtue of tobacco is mentioned (Chapter XXXVIII) 
for the first time in this work, but, as we learn from Strobelberger himself, 
Heurnius has already obtained, experimenting in his own case, the 
cessation of an attack of toothache by holding in his mouth spoonfuls 
of tepid decoction of nicotiana for the space of two hours. 

The same soothing effects may be obtained, says the author, from 
the smoke of tobacco; but he attributes this not to the narcotic action of 
the remedy, but to the fact that it causes the flow of much saliva from 
the mouth and mucus from the nostrils, through which the morbid 
humors which provoke the pain are eliminated. 

To those suffering from odontalgia, says Strobelberger (Chapter XL), 
the internal use of certain mineral waters is also of value, and especially 
that of the waters of Carlsbad (Thermae Carolinae). Like many other 
remedies, they are useful in rendering the secretions more active, favoring 
thus the elimination of morbid substances from the blood. For the 
same object of purifying the organism and dispersing the accumulated 
humors causing the pain, many other means of cure were in usage, such 
as aperients (Chapter XXV), phlebotomy, and arteriotomy (Chapter 
XXVIII), leeching (Chapter XXIX), scarification and cupping (Chapter 

^ Handbuch der Zahnheilkunde, Berlin, 1848, ii, 422. 
^ Geschichte der Zahnheilkunde, p. loi. 


XXX), blistering and cauterizing (Chapter XXXI), masticatories, viz., 
substances intended to be chewed for the purpose of exciting salivary 
secretion (Chapter XXVI), sternutatories, viz., substances which pro- 
voke sneezing (Chapter XXVII), and so forth. 

Like Arculanus, Strobelberger makes a distinction between the real 
and the false cure of odontalgia (^cura vera et cura menJosa), This 
latter he also subdivides in palliative cure and vain cure (Chapter LV). 
The palliative cure is constituted by the use of narcotics and stupefying 
remedies (Chapter LVI), whilst the vain cure is represented by certain 
remedies which he calls "fanatical*' or rather "fantastical.** The vain 
cure, in its turn, undergoes a new distinction, since it comprises three 
species of remedies, that is, the wearing of amulets, the superstitious 
remedies, and the ridiculous remedies. Indeed, this last apellation might 
also fittingly be applied to the preceding ones! 

One would be inclined to believe that the author who qualifies these 
remedies as vain, fantastic, superstitious, and ridiculous was a thoroughly 
unprejudiced man; however, this is not so. Strobelberger, too, had to 
pay his tribute to the dominating prejudices of his century; this mani- 
festly appears from various passages in his book, and especially from the 
Chapters XVI and XLIV. The first of these bears the following title: 
"How to procure immunity from toothache,** and Strobelberger therein 
asserts in all seriousness, basing his assertion on the authority of Rhazes, 
that "if the canine tooth of a lion be suspended to a child's neck before 
the milk teeth fall out and during the eruption of the second teeth, it 
will secure the child immunity from dental pains.** In Chapter XLIV 
the author speaks of those animals whose teeth are useful to man as 
remedies against toothache, and reiterates — lending, as it seems, perfect 
faith thereto — various prejudices that are found in Pliny and other 
writers of antiquity. 

As to the remedies which Strobelberger recognizes as vain — ^that is, 
as devoid of real curative virtue — he remarks that they may nevertheless 
be useful by acting powerfully on the imagination of the sufferer, thus 
causing, in fact, the cessation of pain (Chapter LVII). This clear and 
explicit affirmation of the efficacy of suggestion in a book published 270 
years ago is certainly not without interest. 

If, says Strobelberger, a place is to be accorded, in dental therapeutics, 
to the vain remedies, among these, amulets deserve the preference; and 
the best accredited amulet is the root of the lepidium, already recom- 
mended by Dioscorides, who affirms that if it be hung around the neck 
of the sufferer it will cause the pain to cease. 

One of the superstitious remedies to be used aganst this affection 
(Chapter LVIII), consists in touching the aching tooth with the tooth 
of a dead person, and afterward greasing it with horse's marrow. 


Among the ridiculous remedies (Chapter LIX), the author describes 
one that was especially in use among soldiers. With a piece of chalk 
or of rubble one writes on a table: 

Chiacia Chiacia Chiacia 


One then pricks the tooth with a knife or an iron toothpick until it 
bleeds slightly; then thrusting the point of the instrument, to which 
the blood adheres, into the first cross, then into the second, then into the 
third, and so on, one asks the patient each time if the tooth still pains 
him. Before one gets to the last cross the pain ceases! This stolid 
cure, says the author, has no other value than that of the scarification 
of the part affected. 

Strobelberger held, as did many of the preceding authors, that the extrac- 
tion of a tooth ought to be the last remedy, that is, to be had recourse to 
when all others, including cauterization, which he considers as the last 
but oney have proved ineflFectual. There are cases, however, in which 
the extraction of a tooth is absolutely indicated, and here, by the way, 
the author acquaints us with the following poetic aphorism, which 
expressed the unanimous opinion of doctors: 

Si dens pertusus, vel putrid us esse notatur, 
Corrumpens alios, tunc protinus ejiciatur. 

That is, if one finds that a tooth is hollow or decayed, and corrupts the 
others, it must at once be extracted. 

Strobelberger, like the greater number of his predecessors, is fully 
persuaded that diseased teeth may be made to fall out by the use of special 
remedies; indeed, this clearly appears from the title of the work itself, 
as, without doubt, the reader will already have observed. Such remedies 
are called by him "odontagoga," and he describes them at great length 
in five different chapters (X to XIV) of the second section of his book, 
dedicated to the surgical care of the teeth. 

In regard to violent extraction of teeth, Strobelberger shows still greater 
cautiousness and timidity than Celsus or Abulcasis. He requires that, 
after the gum has been detached, one should endeavor to extract the 
tooth with the fingers or by means of a thread; if, however, this does not 
succeed, one may have recourse to the trifid lever; only at last, that is, 
when even the lever has failed, does he allow the use of an appropriate 
dental forceps. 

Arnauld Gilles, a Frenchman, in the year 1622, published in Paris 
a work whose curious title we will here note: The flower of the remedies 
against toothache} We know nothing else about this publication, 

' Arnauld Gilles, La fleur des remedes contre le mal des dents, Paris, 1622. 


XXX), blistering and cauterizing (Chapter XXXI), masticatories, viz., 
substances intended to be chewed for the purpose of exciting salivary 
secretion (Chapter XXVI), sternutatories, viz., substances which pro- 
voke sneezing (Chapter XXVII), and so forth. 

Like Arculanus, Strobelberger makes a distinction between the real 
and the false cure of odontalgia (^cura vera et cura mendosa). This 
latter he also subdivides in palliative cure and vain cure (Chapter LV). 
The palliative cure is constituted by the use of narcotics and stupefying 
remedies (Chapter LVI), whilst the vain cure is represented by certain 
remedies which he calls "fanatical" or rather "fantastical." The vain 
cure, in its turn, undergoes a new distinction, since it comprises three 
species of remedies, that is, the wearing of amulets, the superstitious 
remedies, and the ridiculous remedies. Indeed, this last apellation might 
also fittingly be applied to the preceding ones ! 

One would be inclined to believe that the author who qualifies these 
remedies as vain, fantastic, superstitious, and ridiculous was a thoroughly 
unprejudiced man; however, this is not so. Strobelberger, too, had to 
pay his tribute to the dominating prejudices of his century; this mani- 
festly appears from various passages in his book, and especially from the 
Chapters XVI and XLIV. The first of these bears the following title: 
"How to procure immunity from toothache," and Strobelberger therein 
asserts in all seriousness, basing his assertion on the authority of Rhazes, 
that "if the canine tooth of a lion be suspended to a child's neck before 
the milk teeth fall out and during the eruption of the second teeth, it 
will secure the child immunity from dental pains." In Chapter XLIV 
the author speaks of those animals whose teeth are useful to man as 
remedies against toothache, and reiterates — lending, as it seems, perfect 
faith thereto — various prejudices that are found in Pliny and other 
writers of antiquity. 

As to the remedies which Strobelberger recognizes as vain — that is, 
as devoid of real curative virtue — he remarks that they may nevertheless 
be useful by acting powerfully on the imagination of the sufferer, thus 
causing, in fact, the cessation of pain (Chapter LVII). This clear and 
explicit affirmation of the efficacy of suggestion in a book published 270 
years ago is certainly not without interest. 

If, says Strobelberger, a place is to be accorded, in dental therapeutics, 
to the vain remedies, among these, amulets deserve the preference; and 
the best accredited amulet is the root of the lepidium, already recom- 
mended by Dioscorides, who affirms that if it be hung around the neck 
of the sufferer it will cause the pain to cease. 

One of the superstitious remedies to be used aganst this affection 
(Chapter LVI II), consists in touching the aching tooth with the tooth 
of a dead person, and afterward greasing it with horse's marrow. 


which, however, to judge from its title, cannot be other than a mere 

DupoNT, another Frenchman, in 1633, published an important pam- 
phlet, which I have, unfortunately, not been able to see. I can, therefore, 
only quote what Sprengel says of it.^ Dupont recommends, in cases of 
obstinate toothache, the extraction and immediate replantation of the 
tooth; which, he says, becomes quite firm again, but will no more cause 
any pain. In confirmation of this, Denis Pomaret related, a little later, 
a case in which a healthy tooth having been pulled out by mistake, and 
immediately put back into the socket and treated with astringent remedies, 
became perfectly firm again. ^ 

Although Abulcasis and Ambroise Pare had already recommended 
the replantation of teeth, the loss of which had been caused by trauma, 
and although Peter Foreest had already made known as a result of 
his own personal experience that the luxation (not, however, complete 
extraction) of a tooth and its successive replantation is capable of causing 
toothache to cease, nevertheless, we must recognize that the merit of 
having elevated replantation in non-traumatic cases to a special method 
of cure must be attributed to Dupont. 

WiLHELM Fabry (1560 to 1634), a German, and native of the small 
town of Hilden near Cologne, better known by his Latin name of Fabricius 
HildanuSy was chief doctor to the city of Berne, and acquired great fame 
as well by his extraordinary professional ability as by his works, consist- 
ing principally in reports of many hundreds of important and instructive 
clinical cases. .He is rightly considered one of the most illustrious German 
surgeons. His writings have largely contributed not only to the progress 
of surgery in general, but also to that of dental surgery in particular. 

One of his observations clearly shows the etiological relation frequently 
existing between a prosopalgia or a supposed hemicrania and a dental 
affection. The case referred to is that of a lady who had been subject 
for six months to violent pain in the upper teeth of one side of the jaw. 
The toothache little by little disappeared, giving place to an obstinate 
cephalalgia in the same side of the head, which gradually became so intense 
as to be perfectly insupportable, the patient being particularly subject 
to it when the weather was cold and damp. After four years of atrocious 
suffering, and after innumerable remedies had been tried without avail, 
Fabricius Hildamus — having had the luminous idea of seeking the cause 
of the evil in the teeth — obtained a complete cure, without further trouble, 
by extracting four of the patient's teeth, which were decayed. 

Nowadays, it is an all-important canon of medical practice, that in 

* Remedes contre le mal des dents, Paris, 1633. 

' Sprengel, Geschichte der Chirurgie, Part II, p. 293. 


every case of neuralgia occurring within the region influenced by the tri- 
facial nerve one should give particular attention to the state of the teeth 
and carefully treat every affection of the same. Notwithstanding — we 
say it with regret — there are still medical men who ignore or neglect 
this precept, and prescribe internal remedies or have recourse to injections 
of morphine when they ought, in the first place, to call in the aid of a 
dentist. How many patients would have been delivered from slow 
martyrdom if the example of the clear-seeing physician of Berne had 
been followed from his days up to the present time! 

Fabricius Hildanus relates, besides, many cases of dental fistula, 
cured by him through the extraction of roots or of decayed teeth. In 
one such case the fistula dated from fourteen years back. Fabricius 
Hildanus, contrary to the opinion of many other doctors, extracted a 
decayed tooth, and by this operation obtained, in a brief period of time, 
the complete recovery of the patient. 

Among the many very important clinical cases cited by Fabricius 
Hildanus, the following deserves to be recorded: In the year 1590 a 
woman presented herself to him who had a hard tumor in the space behind 
the last molar on the right side. The author, after having prepared the 
patient for the operation by the methods then in use (that is, by aperient 
medicine, by bleeding, and appropriate diet), destroyed the tumor by 
the application of escharotic substances. The remaining wound, how- 
ever, defying all the cicatrizing remedies which the author had recourse 
to, one after the other, by reason of its being continually disturbed by 
the movements of the jaws, he then thought of maintaining the dental 
arches in a determined position, and this he obtained by means of two 
pieces of wood somewhat hollowed out above and below, which he placed on 
the right and on the left between the upper and the lower teeth, fixing them 
to the teeth themselves by brass wires passing through two openings made 
expressly in each of the two pieces of wood. In this way he succeeded 
in obtaining the absolute immobility of the jaws and the complete cure 
of the wound in a few days, during which time the patient was nourished 
with liquid food.^ 

A very interesting case, inasmuch as it demonstrated the damage and 
peril which may result from certain absurd means of cure, was reported 
to this author by Claudio Deodato, physician to the Prince-Bishop of 
Basle. The case was that of a patient who, after having tried in vain 
a great number of remedies for a stubborn toothache, finally had 
recourse to the use of aqua fortis; but this substance, which in those days 
was in frequent use for dental caries and for toothache, produced most 

^ Guilhelmi Fabricii Hilandi opera omnia, Francofurti ad Moenum, 1646, Centuria I 
observatio xxxviii, p. ^^. 


deleteribus effects in the patient; that is to say, the loss of ilmost all his 
teeth, necrosis of the inferior jaw. With fistulous sinuses and ulceration 
of the neck, abundant sanious discharge, fever, a cachectic condition, 
incipient necrosis of the upper jaw, etc.* Fabricius Hildaniis, consulted 
by Claudio Deodato about this most serious case, proposed both a local 
and a general treatment, the result of which is, however, not mentioned 
in his book. 

In the fifth ^* centuria of medical and surgical observation^ and cures"' 
we find a case of oral surgery, to which it is worth while briefly to refer 
here. It relates to an epulis situated next to the upper canine of the 
left side. The tumor, already of ancient date, had at this time reached the 
size of a walnut, was very hard, livid in color, irregular in form, and 
adhered somewhat to the upper lip; according to the author, it was of 
a cancerous nature. After the usual preparative measures, Fabricius 
Hildanus proceeded to the ablation of the tumor, and to this end he first 
pierced it with a curved needle and strong thread, in order to get a good 
hold oh it, and he then removed it entirely down to the bone, by means 
of a curved bistoury.' 

Fabricius Hildanus, having dissected several abortive fetuses of under 
four months, was able to verify the exactitude of the assertion made by 
Hippocrates, afterward luminously confirmed by different Italian anato- 
mists, that the teeth begin to be formed during intra-uterine life. And 
with reference to this he also relates the following fact: 

The wife of a Protestant minister gave birth to a female child which 
already had a fully developed tooth, a lower middle incisor, equal in size 
to that of a child of two years old, and which interfered with the sucking 
by injuring the nipple of the mother's breast and the tongue of the child 
Itself. So it was necessary that it should be removed. But it was found 
to be so firm that the surgeon sought in vain to extract it with a thread, 
and was obliged to have recourse to the forceps.* 

Observation XXXI of the third centuria relates a case of rhinoplasty. 
In the year 1590, when the Duke of Savoy made war on the inhabitants 
of Geneva, a girl named Susanna N. fell into the hands of the soldiers, 
who tried to deflower her; enraged at not succeeding in their intent, they 
cut off her nose. Two years later the girl went to Lausanne, the residence 
of J. Griffon, an eminent surgeon of that time, who performed the 
rhinoplastic operation on her in so splendid a manner that one would 

* Cent, iv, obs. xxi, p. 302. 

' The most important of Fabricius Hildanus' works consists of six centuria (hundreds) 
of remarkable cases, published by the author in successive epochs, and which were afterward 
reunited under the title of Ohservationum et curationum chirurgicarum centuria sex, 

* Cent. V, obs. xxvii, p. 406. 

* G. F. Hildani, opera omnia, Epist. ad J. Rheterium, p. loio. 



have taken the new nose for a natural one, not only from its normal 
appearance, but also because the scar was hardly visible. Fabricius 
Hildanus, having had occasion to see and examine the patient several 
times, even up to twenty-one years after the operation, was able to testify 
to the perfect condition of the nose; in the extreme cold of the winter, 
however, it was apt to become livid at the point. He does not describe 
the operative process followed by Griffon, but merely says that the first 
inventor of this operation was Gaspare Tagliacozzi, of the University 
of Bologna, and that Griffon had undertaken the reproduction of the same 
from his own conception of it, based on the information imparted to him in 
conversation, by an Italian who had been operated upon by Tagliacozzi. 
JoHANN ScHULTES (1595 to 1645), ^ physician in Ulm, was the author 
of a very important work entitled Armamentarium chirurgicumy in which 
are given plates and descriptions of almost all the surgical instruments 
that had been in use up to that date. As to the part relating to dental 
and oral surgery, we find the following instruments named in this work: 

1. Several kinds of pelicans; an instrument which was so called froni 
its resemblance to the beak of the bird of the same name, and used for 
extracting the molar teeth. 

2. The common dental forceps, then named cagnolo by the Italians, 
because of the supposed likeness to a dog's muzzle. 

3. The crow's beak forceps {rostrum corvinum)y designed for the 
extraction of dental roots, and, therefore, corresponding to the rhizagra 
of Celsus. 

4. Two special dental forceps, or dentiducesy for the removal of teeth 
which could not be extracted either with the pelican or with the common 
dental forceps. 

5. Bifid and trifid elevators (yectes bifidi et trifidi)y to be used for the 
extracting of incisors and canine teeth, as well as roots. 

6. Dentiscalpia for detaching the gum from the tooth before proceeding 
to extract it, in order that this may be the more easily accomplished and 
with less danger. 

7. A silver funnel or cannula (infundibulum seu fistula argentea)y 
for nourishing patients affected with trismus, by conveying liquid food 
into the fauces, through the free space behind the last molars. 

8. Forceps more or less like in form to the beak of the parrot or the 
vulture (rostrum psittacinum et vulturinum)y for the removal or resection 
of teeth that have grown in abnormal positions. 

9. A screw dilator (dilatatorium cum cochlea)y for gradually opening 
the dental arches in cases of spasmodic constriction of the jaws.* 

* Joannis Sculteti, Ulmensis, armamentarium chirurgicum, Francofurti, 1666, Plates 


Marco Aurelio Severing (1580 to 1656), of Tarsia, a celebrated 
professor of surgery in the Neapolitan University, had a great predilection 

A plate from Schultes' " 

n chirurgi 

for the use of the cauterizing iron, which he also used very frequently 
in curing caries and other dental diseases. At times, to effect a cessation 
of violent toothache, he would have recourse to the cauterization of the 


aritiKelix! Against flacbidity 6( the guhls arid loosferiing of the teeth he 
also Used cauterization, dii^J>provIng the usie of aistrihgent substances; 
as these cannot get so far as the roots of the affected teeth. Severino 
boasts of having cured by cauterization at least two hundred cases of 
dental diseases. 

Lazare RivifeRE (1589 to 1655), a professor at the University of 
Montpelier, also known by his latinized name of Lazarus Riverius, 
treats of dental affections and their cure, in various parts of his works, 
considering them, however, almost exclusively from a medical point of 

He speaks first of all of the different causes of odontalgia, and, among 
these, does not omit to mention worms. These, he says, may be generated 
in the carious cavities, owing to the putrefaction of substances retained 
in their interior. Whenever odontalgia is caused by worms, the pain, 
says Riviere, is not continuous, but ceases and returns at brief intervals; 
besides, the sufferer perceives at times the movement of the worm in- 
side the tooth ! 

What one reads in the works of this author as to remedies to be used 
for odontalgia clearly demonstrates how irrationally dental diseases were 
treated in the seventeenth century and what tortures were inflicted on the 
patients. In many cases, and especially when the pain was held to be occa- 
sioned by "hot humors," the treatment was begun by bleeding in the arm. 
The following day an aperient was administered. Afterward, if the pain 
still persisted, the sufferer was cupped in the region of the scapulae or of 
the spine, blisters were applied to the nape of the neck or behind the ears, 
resinous plasters to the temples; all this without taking into account the 
remedies which were introduced into the ears, or the various medications 
or operations performed on the aching part itself, and many other things 
besides. In fact, in order to cure a toothache, the whole body of the 
sufferer was seized upon and put to torture, and in the majority of cases 
they assuredly finished by extracting the diseased tooth ! When we reflect 
on the extraordinary frequency of dental disorders we cannot do less 
than recognize that the dentists, by the radical change effected in the 
methods of treatment, have diminished in no small degree the suffer- 
ings of humanity! 

According to Riviere, the small veins (sic) that nourish the teeth pass 
through the ear (!); and this would explain how the cessation of a tooth- 
ache may be obtained by the introduction of certain remedies into the 
meatus auditorius externus. Relief may be obtained, for instance, by 
dropping oil of bitter almonds into the ear on the side affected by the pain, 
or by allowing the vapor of hot vinegar, in which pennyroyal or origanum 
has been boiled, to penetrate into it. Others, adds the author, pour a 
little pure vinegar into the ear, which is especially efficacious against 


"hot fluxions." When, however, the toothache depends on a "cold 
fluxion," it calms the pain wonderfully to drop into the ear a tepid mixture 
of garlic juice and theriac. The same advantage, says the author, may 
be obtained by introducing a piece of garlic, peeled and cut into the form 
of a suppository, into the ear. 

The author also makes a lengthy enumeration of anodyne and narcotic 
remedies (among which opium), observing, however, that those remedies, 
unless the vehemence of the pain obliges the use of them, ought not to 
have the preference, it being much more rational and much more advan- 
tageous to institute a cure which aims directly at the cause itself of the pain 
(fluxions, worms, etc.). 

He informs us that Amatus Lusitanus, a celebrated physician of the 
sixteenth century, extolled, as a remedy for toothache, a decoction of gum 
sandarach in wine and vinegar; the said decoction was to be made with 
an ounce of sandarach in six ounces of wine and the same quantity 
of vinegar, and ought to be kept in the mouth some length of time, 
whilst hot. 

Riviere further speaks of various masticatories, which were composed 
of mastich, staphisagria, pyrethrum, henbane, etc. 

He also mentions oil of cloves, which even then was used against tooth- 
ache, by introducing into carious cavities a small piece of cotton-wool 
soaked in it. Oil of camphor was used in the same manner, but the most 
eflBcacious of all, according to the author, was oil of boxwood. 

As to worms in the teeth, they may be destroyed by the use of bitter 

In the case of a caries penetrating into the inner cavity of the tooth, 
to effect the cessation of pain, it is necessary to burn the nerve with the 
actual cautery, or with aqua fortis, or with oil of vitriol. If this be 
repeated several times, the tooth gradually falls to pieces. 

After having enumerated all these remedies, the author speaks of the 
extraction of the teeth, and of all the precautions with which this must 
be carried out in order to avoid the various accidents which may result 
from the operations and may even, sometimes, become a cause of death. 

When abundant hemorrhage follows the extraction of a tooth, this 
may often be made to cease by applying a small, very compact ball of 
linen into the alveolus and maintaining it there by pressure during one 
or two hours. Should this not suffice, one can combine with compression 
the use of astringent substances. Finally, as a last remedy, use may 
be made of the red-hot iron. 

In the case of timid patients, who shrink from an instrumental opera- 
tion, recourse may be had to eradicating remedies, the author being fully 
convinced of their efficacy. Indeed, one of these — helleboraster — is 
said to be so powerful that, when rubbed on the teeth, these fall out 


within the space of a few hours ; for which reason it is absolutely neces- 
sary, in making use of it, to cover over the neighboring teeth with wax, 
so that the healthy ones may not also fall out, as happened, says the 
author, in the case of a poor peasant. 

The internal use of mercury, and even the use of certain mercurial 
preparations used by women as cosmetics, is of damage to the teeth and 
imparts to them a blackish or dirty looking color. 

Numerous remedies exist for cleaning the teeth, but according to 
Riviere the best way of cleaning them consists in rubbing them with 
a small stick immersed in sulphuric acid {spiritus sulphuris aut vitrioli) 
and afterward drying them with a piece of linen. This remedy not 
only cleans and renders the teeth white, but it preserves them also from 
caries! If the teeth are very dirty, the spirit of vitriol may be used 
pure; otherwise one mixes it with mel rosatum or with water. 

The great enthusiasm shown by Riviere for the above-mentioned 
remedy does not, however, derive from a long experience, made by him- 
self or by others, of its advantages, but is based principally on a fact 
referred to by Montanus, and which, ^ we will here recount, because, from 
it, one clearly perceives how credulously our forebears accepted general 
affirmations and formulated therapeutic precepts. 

Montanus recounts in one of his writings, how, being in Rome in his 
early youth, he became acquainted with a woman of about twenty years 
of age, known by the name of Maria Greca (by the way the author 
speaks of her, one is led to suspect she was a courtesan); and how, having 
seen her again, thirty years later, and found her in pretty much the same 
conditions as formerly, he expressed his surprise at this; whereupon 
Maria Greca told him that she herself believed that she owed the con- 
servation of her beauty to the habit, already of many years' standing, 
of using one or two drops of oil of vitriol every morning, as a friction for 
the teeth and gums. In her youth she had had very bad teeth, but by 
reason of this cure they had become, and were at the time being, beautiful 
and perfectly firm; the gums also were in excellent condition; it seemed, 
therefore, to her that this conservation of health and freshness, in spite 
of her fifty years, depended precisely on the daily use, in the manner 
described, of oil of vitriol!^ 

Riviere, besides, recommends tobacco ashes for cleaning the teeth, a 
counsel not yet given by any previous author. He also gives the formulae 
for two dentifrice powders, the basis of which is alum; he calls attention 

* Giovanni Battista Montano (1488 to 1551), of Verona, Professor of Medicine at Padua. 

* It is marvellous that an intelligent physician should have lent faith to such a story, related, 
too, by such a woman, never reflecting that the daily use of sulphuric acid for the space of 
thirty years, that is, about 11,000 applications, instead of curing and beautifying bad teeth, 
would certainly rather have had the effect of totally destroying the denture of even a mastodon. 


to the great importance of taking assiduous care to keep the teeth clean, 
and advises that after each meal the residues of food be removed from 
the interstices of the teeth and the mouth well rinsed with wine.* 

NicoLAUS TuLP, in Latin, Tulpius (1593 to 1674), a distinguished 
physician and anatomist of Amsterdam, contradicts the then prevailing 
opinion among doctors, that is, that the cure of dental affections and the 
operations relating thereto were matters to be held in little account. 
He observes that diseases of the teeth may give rise to the most serious 
consequences, which can even be the cause of death, and are, therefore, 
worthy of being taken into equally serious consideration as all the other 
diseases of the several parts of the human body. 

This author relates a clinical case tending to demonstrate how incisions 
made in the gums, advised in the first place by Vesalius, in order to 
facilitate the erupting of the last molar, are not always exempt from 
danger. A young doctor of Amsterdam, by name Goswin Hall, being 
tormented by insupportable pain caused by the difficult eruption of a 
wisdom tooth, had the gum lanced above it. But the pain, instead of 
diminishing, became worse; fever and delirium supervened, followed by 
death! (Here, however, we must be allowed to observe that nothing 
detnonstrates that the real cause of death was the lancing of the gum, 
or that without this the case would have had a different termination. 
An event can occur after another and yet be quite independent of the 
former and result from quite different causes.) 

Among the cases cited by Tulp, the following is also worthy of mention. 
He relates having arrested a violent and persistent attack of hemorrhage, 
which came on after the extraction of a tooth, by applying and compress- 
ing a piece of sponge inside the alveolus.' 

The belief that dental caries and toothache could be caused by worms 
was, at that time, still in full vigor, and it gained still greater force by 
reason of observations recorded by different scientists, whose affirmations 
could with difficulty be doubted, for at that period the greater number 
still swore blindly in verba magistri. 

Oligerus Jacobaens (1650 to 1701), a Danish physician and anato- 
mist, who taught in the University of Copenhagen, declared that in scraping 
the decayed cavity of a tooth that was the cause of violent pain, he had 
seen a worm come forth, which, having been put into water, moved about 
in it for a long time. 

Martin Six, having split some decayed teeth a short time after they 
had been extracted, asserts that he determined the existence of worms in 

^ Lazari Riverii, opera medica omnia, Genevac, 1737; Praxeos medicac liber sextus, cap. i; 
De dolore dentium, cap. ii; De dentium nigredine et erosione. 

' Nicolai Tulpii, Amstelodamensis, Osservationes medicae, Amstelodami, 1685, lib. i, 
cap. xxxvi, p. 68; cap. xlix, p. 90. 


them. (It is probable that this observer, as well as others, mistook the 
dental pulp for a worm, an unpardonable error, in truth, at a time when 
the anatomical constitution of the teeth had already been very well 
studied by several scientists, and especially by the celebrated Bartolomeo 

Gabriel Clauder (1633 to 1691) not only believed in dental worms, 
but maintained besides that these were the most frequent among all the 
causes of toothache. In a certain way, to sustain this opinion of his, he 
relates a case in which a tooth of healthy appearance being the seat of 
great pain, a tooth-drawer had asserted that there must be a worm in 
its interior; and, in fact, on the tooth being extracted and afterward split, 
the little animal whose existence the tooth-drawer had divined, was found 
to be existing inside of it! 

Philip Salmuth asserts that by using rancid oil he got a worm out 
of the decayed tooth of a person suffering from violent toothache, thus 
causing the cessation of the pain. The worm, he says, was an inch and 
a half in length (!) and similar in form to a cheese maggot. 

NicoLAUS Pechlin (1646 to 1706), professor of medicine at Kiel, 
testifies to having seen five such dental worms, like maggots, come out 
by the use of honey, though he does not say whether they issued from 
several cavities or from one only! 

Gottfried Schulz. But all this is nothing compared to what 
Gottfried Schulz has dared to assert, viz., that by using the gastric juice 
of the pig, worms of great size can be enticed out of decayed teeth; some 
of these even reaching the dimension of an earth-worm! 

It is not much to be wondered at that these things should have been 
blindly believed in, if we reflect that only a short time previous to this 
the story of the golden tooth had been taken seriously by men of great 
erudition, and that in the very epoch of which we are speaking the illus- 
trious anatomist Thomas Bartholin (16 16 to 1680), of Copenhagen, 
relates having seen a man, at Padua, who had an iron tooth! Besides, 
the possibility of such a phenomenon was explained in a most curious 
manner by Thomas Minadous, who explained that in the same way 
as iron is generated in the macrocosm, that is, in the world, so it is 
equally admissible that it may be generated in the microcosm, that is, 
in man!^ 

Nathaniel Highmore. In the year 165 1 the English physician and 
anatomist Nathaniel Highmore (1613 to 1684), of Hampton, published 
a treatise on anatomy (^Corporis humani disquisitio anatomicay etc.), by 
which he acquired a celebrity superior, perhaps, to his merits. This 
work, however, served without doubt to diflfuse the knowledge of an 

* Sprengel, Geschichte der Chirurgie, vol. ii, pp. 294, 299. 


anatomical fact of the highest importance, especially from the point of 
view of dentistry and surgery. 

There is no doubt that the existence of the maxillary sinus was already 
known before Highmore, the celebrated anatomists Vesalius, Ingrassias, 
Eustachius, and Fallopius having spoken of it very clearly; only through 
ignorance of the history of anatomy has it been affirmed by many that this 
cavity was discovered by Highmore, to whom is only due the merit of 
having described the maxillary sinus, by him called antruniy most accu- 
rately, and of having made known the possibility of a communication 
between it and the mouth. Highmore calls attention to the fact that the 
inferior wall of the antrum often presents small projections, which cor- 
respond with the tops of the alveoli, and that the osseous lamina which 
interposes between these latter and the maxillary sinus is often extremely 
thin; for which reason, it may easily happen that, in extracting one of the 
teeth below the cavity, one may bring away together with the tooth the 
small osseous plate that forms the bottom of the alveolus, thus leaving 
the maxillary sinus open at its inferior part. With regard to this, he 
refers to a most interesting case which afterward acquired a high degree 
of notoriety. It relates to a lady who had suffered from toothache for 
some years, and who from time to time had had several decayed teeth ex- 
tracted, without, however, finding relief. The pain only ceased after the 
patient Jiad had the left upper canine removed. But after this operation 
an incessant flow of humors from the alveolus of the extracted tooth took 
place. The patient, in great anxiety at this circumstance and desirous 
of seeing clearly into the causes of it, herself explored the affected part 
with a silver probe, the entire length of which penetrated into the cavity, 
producing in the patient the effect of its having reached the eye. Still 
more amazed, and urged on by the desire of becoming still better ac- 
quainted with the extent of the evil, she now made use of a long feather, 
which she had previously stripped, and discovered to her painful surprise 
that this new instrument of exploration entered to so great a distance 
that it, according to her idea, penetrated into the skull. From this she 
derived argument for the belief that the morbid phenomenon had its 
origin in her brain. Believing herself affected with a serious malady, 
she consulted Highmore, who had the satisfaction of being able to tran- 
quillize her completely by making her understand that the jaw bone is 
hollow in the inside, and that its cavity had remained open underneath 
in consequence of the extraction of the canine tooth; and also, that the 
feather had not penetrated to such a distance as she supposed, but had 
curved inside the bone. As to the discharge which had given so much 
trouble and alarm, Highmore considered it quite a natural circumstance, 
derived simply from the opening of the antrum, as he held that in many 
cases the maxillary sinus contains mucus, and that this condition was. 


therefore, altogether normal. So he did not propose any treatment, 
and the lady thenceforth supported her infirmity with resignation. 

This most interesting case soon became generally known, and contrib- 
uted, without doubt, not a little to attract the attention of medical men 
to the anatomical peculiarities which Highmore had pointed out in the 
upper maxillary bone, thus causing his name to become inseparably 
associated with the maxillary sinus. 

It is evident, however, that Highmore never even suspected to what 
very important practical applications his description would give rise. 
He knew nothing about the diseases of the antrum, and believed that, 
even in perfectly normal conditions, this cavity is often filled with liquid; 
the idea, therefore, of its being advisable, in certain cases, to extract a 
tooth and perforate the alveolus in order to give exit to the liquid con- 
tained in the maxillary sinus never occurred to him. 

About fifty years went by before a rational treatment for affections of 
the antrum was initiated, the merit of which, as we shall see at its time 
and place, was due to William Cowper. During that half century 
maladies of the maxillary sinus continued to be badly diagnosticated and 
badly treated. 

Bernardo Valentini. In the year 1686, that is, thirty-five years 
after the publication of Highmore's book, Bernardo Valentini, professor 
at the University of Giessen, described a case of tumefaction and abscess 
in the cheek, treated by him with emollient remedies, and in which, 
although according to him caries of the underlying bone did not exist, 
the separation of a sufficiently large osseous fragment took place. With- 
out doubt the affection of the cheek was derived in this case from some 
disease of the antrum; however, it would appear that Valentini did not 
in the least perceive any such casual relation, as he makes no allusion 
whatever to it.* 

Antonio Molinetti, professor at the University of Padua, had, how- 
ever, ten years previously, diagnosticated and cured an affection of the 
antrum by means of an operation. In his book Dtssertattones ana" 
tomi co-pat hologicay published at Venice in 1675, Molinetti relates that 
in a case of abscess of the maxillary sinus, which caused the patient great 
suffering, he performed the operation of trepanning the upper maxillary 
bone anteriorly, after incision of the soft parts overlying it. In a certain 
wav we may, therefore, consider Molinetti as a precursor of William 

Having spoken of the very important anatomical fact illustrated by 
Highmore, we will now also speak briefly of those authors who, in the 
seventeenth century, occupied themselves with the anatomy of the teeth. 

^ Sprengel, op. cit., p. 297. 


Their number is sufficiently large; we will, however, only make mention 
of such as contributed to the development of this branch of science, or 
who, at least, expressed some opinion worthy of note. 

The celebrated anatomist Adrian Spiegel (1578 to 1625), better known 
by the Latinized name of Spigeliusy wrote nothing noteworthy about 
the teeth, but he appears to have been the first to affirm that the teeth 
are more firmly fixed in the alveolus, when their roots are curved after 
the manner of hooks.* 

DiEMERBROEK, a Dutchman, relates several cases of dental anomalies, 
as for example, of teeth being cut in the palate, and which injured the 
tongue. The author cites his own case, relating that having had a 
canine tooth extracted when well advanced in years, it was, nevertheless, 
succeeded by a new one. He relates, besides, that he had seen in Utrecht 
a woman, aged fifty-six years, who again cut two incisors after having 
lost the former ones two years previously. Apart from this, Diemer- 
broeck tells us nothing of interest or importance regarding the teeth, 
often repeating old ideas, the falseness of which had already been lumin- 
ously demonstrated. For instance, he says that the permanent teeth are 
developed from the roots of the deciduous ones remaining in the alveoli; 
an unpardonable error for an anatomist of the seventeenth century, for 
which he was afterward taken to task by Duverney.' 

Thomas Bartholin, whom we have already mentioned, speaks of 
a tooth which had made all the round of the alveolar border; that is 
to say, of a dental arch constituted by a single piece; and the Italian 
anatomist Bernardo Genga makes mention of an analogous case.* 
It is superfluous to add that these authors allowed themselves to be 
deceived by false appearances, owing especially to an abundant and uni- 
form deposit of tartar on the surface of the teeth and in their interstices, 
which gave to the dental arch the appearance of one continuous piece. 

RiNALDUS Fredericus, in his erudite dissertation entitled De dentium 
statu naturali et prceternaturaliy spoke of the dental system with sufficient 
thoroughness, if we consider the epoch in which he wrote. He commences 
his work with a long chapter on the importance and dignity of the teeth 
(Jignitas dentium). Among other things, he relates that formerly, in 
certain parts of India, the teeth were so highly valued as to be offered 
in sacrifice to the gods. He says, too, on the authority of certain authors, 
that the ancients were led to believe that the teeth served for the resur- 
rection of the body, from the circumstance of their not showing signs of 
corruption when found in sarcophagi. 

' Blandin, Anatomie du systeme dentaire, Paris, 1836, p. 26. 

* Blandin, op. cit., p. 27; Portal, Histoire dc Tanatomie et dc la chirurgie, Parii, 1770, 
vol. iii, p. 495. 
' Blandin, op. cit., p. 26 ; Portal, op. cit. 


Discoursing of the genesis of the teeth, Fredericus says that "every 
tooth is at first enclosed within a follicle, that is, in a frail, skin-like 
membrane, in the same manner as the grain in the wheat-ear." Taking 
this cornparison as his point of departure,* he gives to dentition the name 
germt nation. 

This author says that the teeth of the Ethiopians and of the Indians 
are generally whiter than those of the northern peoples, but that those 
of the Indians soon lose their primitive whiteness by reason of the widely 
diffused habit of chewing betel-nuts. 

Fredericus refers to an experiment which, according to him, demon- 
strates the "sympathetic relations" between the teeth and the ear (whilst 
in reality it only proves the facility with which sounds may be transmitted 
through solid bodies). "If, by night," says he, "one holds tightly 
between one's teeth the end of a stick, stuck upright in the ground, 
one hears the footsteps of a person approaching from afar much more 

Through the researches of three great men, Marcello Malpighi, 
Friedrich Ruysch, and Antoni van Leeuwenhoeck, an altogether new 
science arose in the seventeenth century, viz., histology, or the anatomy 
of the tissues, whose revelations contributed not a little to the develop- 
ment of modern odontology. 

Marcello Malpighi (1628 to 1694), the celebrated Italian anatomist, 
was the initiator of microscopic observations on the tissues, and is, there- 
fore, justly considered the founder of histology, within the range of which 
he made most important discoveries.^ 

Friederich Ruysch (1638 to 1731), professor at Amsterdam, rendered 
his nam^ illustrious particularly by bringing to a high degree of perfection 
the processes of anatomical preparations and of embalming.' 

His magnificent injections, carried out with a method of his own 
invention, enabled him to trace the most minute vascular ramifications 
and to demonstrate the existence of capillary vessels in parts where their 
presence had as yet never been suspected. 

Ruysch studied accurately the anatomical constitution of the teeth, and 
especially their vessels. He called attention to the membrane which lines 
the maxillary sinus, and discovered in it a number of bloodvessels. 

But in addition to his purely anatomical observations, this author also 
merits our consideration from the point of view of pathology. He con- 
firmed a most important fact to which allusion had already been made 
by preceding authors, that is, the atrophy of the alveolar parietes as 

' ^ofus dens primum inclusus est folliculo seu membrana tenui ac pellucida non secus ; 

'^-"Jne. p. 221. * Bouillet, op. cit.. 


following on the extraction or oh the falling out of teeth. Ruysch, how- 
ever, makes the observation that atrophy of the alveolar parietes may 
also precede the falling out of the teeth, and rather be the cause than an 
effect of it. In such cases the teeth, before falling out, always become 
more and more loosened, proportionately to the atrophic process. This 
pathological condition, against which none of the Astringent rehiedies 
habitually used are of avail, is mostly considered, says Ruysch, to be 
owing to scurvy; but, he adds, the accumulation of tartar may also 
be the cause of it. Substantially, Ruysch affirms the relation existing 
between the accumulations of tartar and the production of that very 
frequent disease that was afterward named expulsive periodontitis or 
alveolar pyorrhea. 

This author also relates two cases of polypous affection of the maxillary 
sinus. In one of these cases, the existence of a polypus in the maxillary 
sinus was determined by Ruysch while dissecting a corpse. The other 
case relates to a female patient upon whom two surgeons had performed 
the extraction of several molar teeth and the extirpation of an epulis 
believed by them to be of a malignant character. After the operation they 
cauterized the diseased part to a great depth with a red-hot iron, reaching 
as far as the maxillary sinus, which remained open, arid from which 
Ruysch afterward extracted with his little finger several polypi.* 

Antoni Van Leeuwenhoek (1632 to 1723), like the preceding author, 
a Dutchman, was the first maker of powerful microscopes, by means of 
which he made many important discoveries; among others, that of the 
tubular structure of the dentine or tooth bone. This discovery he made 
known and demonstrated in the year 1678, before the Rbyal Society in 
London. In his description of the structure of the teeth, Leeuwenhoek 
says that 600 to 700 of the dentinal tubuli have hardly the consistence of 
one hair of a beard. ^ 

In the year 1683 he discovered in the tartar scraped ftom between the 
teeth a form of microorganism upon which he laid special stress. This 
observation he embodied in the form of a contribution which was pre- 
sented to the Royal Society of London on September 14, 1683. This 
paper is of particular importance, not only because of the careful, objective 
nature of the description given of the bodies seen by hiiti, biit also for the 
illustrations which accompany it. From a perusal of the text and an 
inspection of the plates, there remains little room for doubt that the 
bodies described by Leeuwenhoek were not animalcules, as he believed, 
but bacteria.' 

* Friderici Ruyschii observationum anatomico-chirurgicorum, centuria, Amstelodami, 
1 691; Portal, op. cit., vol. iii. 

* Portal, op. cit., vol. iii. 

' A. C. Abbott, The Principles of Bacteriology, Philadelphia, 1905, p. 19. 


DoMENico Gagliardi, professor of anatomy and of medicine at Rome, 
published an excellent work on the anatomy of the bones/ in which he 
occupies himself not only with the structure of bones, properly so called, 
but also with that of the teeth. He considers the enamel to be formed 
by parallel and contiguous fibers, coated, so to speak, by a concreted 
juice, sui generis^ which acquires a much greater consistence than that 
of the bones. Gagliardi says that by rubbing teeth hard together, or 
striking them with a steel, he was able to extract sparks from them.' 

Jean Duverney (1648 to 1730), a celebrated French anatomist, 
wrote a good monograph' about the teeth. As different anatomists of 
the sixteenth century had already done, he examined many fetal jaws 
in order to study in them the formation of the teeth. In relating his 
observations, he says that he found in every alveolus a mass of soft viscous 
matter, having the form of the tooth that is to derive froni it, and which 
may be considered as its nucleus. This nucleus is entirely surrounded 
by a membrane, which the author likens to that which surrounds the 
fetus, and to which he gives the name of choroid membrane. From the 
surface of the nucleus a gelatinous juice transpires, which, thickening 
in layers, forms the enamel and the rest of the tooth. The choroid 
membrane is abundantly furnished with nerves, and with blood and 
lymph vessels. Into the interior of the teeth penetrate vascular and 
nervous branches which serve to maintain its vitality. In fetal jaws one 
finds, besides the germs of the deciduous teeth, also those of the permanent 
ones. The "choroid membrane" does not follow the tooth when it 
issues from the alveolus; it remains instead within the latter, forming 
the peridental membrane. 

Duverney says that in old people the root cavity diminishes in so con- 
siderable a manner, and the vessels are so compressed that they almost 
entirely disappear. It is then that a period of decadence begins in the 
tooth, it is more feebly nourished, wears away more rapidly than hitherto, 
and becomes shorter. 

The author also speaks of senile atrophy of the jaws, especially of. the 
alveolar processes. With regard to this, he observes that if in old age 
the lower jaw advances beyond the upper, this depends wholly on the 
disappearance of the alveolar border, which projected more in the upper 
than in the lower one. 

Duverney admits the existence of direct vascular relation between the 
gums and the teeth; because in the case of diseases of the gums it is rare 
not to find the teeth altered as well. 

From the point of view of the development and nutrition of the teeth, 

* Anatome ossium, Romae, 1689. * Portal, vol. iv, p. iii; Blandin, p. 28. 

' Jean Guichard Duverney, Memoirc sur les dents, Paris, 1689. 


Duverney finds much analogy between the tusks of the elephant, the 
teeth, properly so called, the feathers of birds, and the hair of mammifera.* 

Gottfried Bidloo, a Dutch anatomist, expresses the idea that the 
air contributes, after the eruption of the teeth, to hardening them. He 
did not, however, give any proof of this opinion of his.' 

Clopton Havers, an Englishman, wrote a book on osteology, by which 
he acquired great reputation,' and in which he treats as well of teeth 
and their structure. This author believes the enamel of the teeth to 
be of the nature of stone, and the ivory of the nature of bone. The 
dental roots, which, he says, are precisely of a bony nature, are .covered 
over with a periosteum, which is in close relation with the gums and with 
the periosteum of the jaw bone. Clopton Havers held that the dental 
follicle no longer furnishes any nourishment to the enamel from the 
moment that this has reached its perfect formation. On the other hand, 
he assures his readers that he has observed, through the microscope, 
nervous threads which, departing from the bulb of the tooth, traverse the 
ivory through small canals, arriving thus at the periosteum. By this 
anatomical disposition the sensibility of the teeth may, according to him, 
be explained.* 

Having made this passing allusion to the anatomy of the teeth in the 
seventeenth century, we will now resume the illustration of those facts 
relating to the pathological and curative part of the science. 

Walter Harris, an Englishman, in a pamphlet on acute infantile 
maladies,* recommends again, in cases of difficult dentition, the incision 
of the gums, a curative practice which had already fallen into disuse." 

In the authors of that time we find registered a great number of cases 
of epulis. HiOB Van Meekren speaks of an enormous tumor of the 
gum that developed in consequence of a traumatic action which had 
occasioned the loss of a tooth. Before deciding on the extirpation of the 
tumot, the author thought well to pierce it with a bistoury, to be able to 
judge whether its ablation might not possibly give rise to a dangerous 
hemorrhage. The wound having bled but little, he proceeded to operate; 
but the tumor was so large that it was necessary to remove it in various 

The same author refers to a case of a soft epulis, bleeding easily, that 

* Blandin, op cit.; Portal, vol. iii, p. 495. ' Blandin, p. 31. 

* On Some New Observations of the Bones and the Parts Belonging to Them, London, 
1 69 1. The accurate description given by Havers of the canals containing the nourishing 
vessels of the bone has caused these canals to be known, even up to the present day, by the 
name of "Haversian canals." 

* Portal, vol. iv, p. 134; Blandin, p. 31. * De morbis acutis infantum, London, 1689. 

* Sprengel, Geschichte der Chirurgie, vol. ii, p. 298. 

T Meekren, Observationes medico-chirurgicz, cap. xv, p. 84. 


developed after a badly performed dental extraction. It was to be foreseen 
that the ablation of such a tumor would give rise to an abundant hemor- 
rhage. This was, however, staunched by simply using astringent powders, 
without having rfecoursfe to the actual cautery, which the operator had 
held in readiness.* 

Daniel Major, wishing to remove a large epulis by tying it, was 
obliged, in order to keep the ligature in position, to pass the thread through 
a circular incision made at the base of the tumor. He Rrst used a 
thread of silk, afterward a silver one, and tightened the ligature every 
day until the epulis fell off.' 

JoHANN AcoLUTHUs was obliged, in brder to extirpate a large epulis, 
to previously split the labial commissure. After the ablation of the 
principal mass of the tumor, he destroyed the remaining pkrt of it by 
application of the red-hot iron.' 

One reads of other cases of epulis in Stalpaart van der Wyl, Mercklin, 
Preuss, Bern, Valentini, etc. This last author even speaks of an epi- 
demic of epulis. However this may be, it is very probable that epulis 
was much more frequent in past times than it is now, and this probably 
depended partly on the incongruous modes of treating diseases of the 
mouth, and partly on the slight attention paid to cleanliness of the teeth. 

KoRNELis VAN SooLiNGEN, a celebrated Dutch physician and surgeon, 
who flourished toward the end of the seventeenth century, speaks con- 
temptuously of dental operations, and especially of extractions. Hie says 
that such operations ought to be left to charlatans, used to taking out 
teeth with the point of the sword, and to doing many other things of like 
nature! This unjust contempt was at that time widely diflFused in the 
medical class, it resulted, however, substantially, from the great difficulties 
encountered by doctors and surgeons in general, in performing the 
operation of extraction, owing to want of practice, and also from the 
desire to avoid the responsibility of the accidents to which the extraction 
might give rise; so true is this, that an author of the preceding century, 
Theodor Zwinger (1538 to 1588), a celebrated Swiss doctor and pro- 
fessor at Basle, had declared with great frankness that the extracting of 
teeth ought to be left to barbers and charlatans, as it might easily occasion 
unpleasant accidents, such as fractures of the jaw, laceration of the gums, 
serious hemorrhage, and the like. 

In spite of his contempt for practical dentistry, Kornelis van Sbolingen 
takes the treatment of dental aflFections into attentive consideration. For 
the stopping of carious teeth, he recommends a mixture similar to that 
which Rhazes had recommended many centuries before, that is, a cement 
of mastic and turpentine; because, says he, when the stopping is made 

' Op. cit., cap. xxviii, p. 120. ^ Sprengel, vol. ii, p. 298. ^ Sprengel, loc. cit. 


with metallic substances, it is never so perfect as to entirely impede the 
penetration of moisture. 

Great credit is due to Kornelis for having first brought into usage 
the instrument makers' emery wheels for grinding down sharp edges 
of teeth, thus initiating the practice of trepanning the teeth with sphere- 
shaped burs.* 

Paul Wurfbein refers to a case of extensive necrosis of the lower 
jaw, in which a certain Dr. Burlin having removed the necrotic portion, 
regeneration of the bone took place. 

Friederich Dekkers (1648 to 1730) refers a similar case, in which, 
although quite one-half of the lower jaw had been removed, the bone 
formed again completely.^ 

Benjamin Martin, apothecary to the Prince de Conde, was the 
author of a pamphlet on the teeth,' in which he gave a succinct descrip- 
tion of these organs and spoke briefly of their diseases. He shows him- 
self decidedly opposed to the use of the file and to the application of false 
teeth, because, according to him, both of these things may be the cause 
of great harm. With regard to the file, he says that nothing so easily 
tends to loosen the teeth as the use of this instrument, not to speak of 
various other inconveniences, among which is the danger of opening the 
interior cavity of the tooth.* 

Matthias Gottfried Purmann (1648 to 1721), a celebrated surgeon 
of Breslau, was the first to make mention of models in dental prosthesis. 
As to the mode in which these models were obtained, some admit as 
natural that he first took a cast, and formed the model on this; but as 
Purmann does not hint in the least at such a process, the supposition is 
altogether gratuitous. Indeed, his description rather excludes any prob- 
ability that the model was taken from a cast. Here is the literal trans- 
lation, as nearly as possible, of the passage in which Purmann speaks 
of artificial teeth and of the mode of applying them. 

"The front teeth, or pronouncing teeth, ought, when they are wanting, 
to be substituted by artificial ones, in order to avoid defects of pronunci- 
ation, as well as to obviate deformity of the mouth, and this is carried out 
in the following manner: One has other teeth made of bone, or of ivory, 
according to the number, the size, and the proportions of those wanting; 
for which purpose one may previously have a model executed in wax, 
reproducing the particular conditions of the teeth and jaws, in order 
afterward to make and exactly adjust the whole on the pattern of it; 
then, when the base of these teeth is well fitted on the jaw and small 

' Soolingen's Manuale operatien der chirurgie, Amsterdam, 1684. 

* Sprengel, op. cit., p. 3CX). 

* Dissertation sur les dents, a Paris Chez Denys Thierry, MDCLXXIX. 

* Portal, op. cit., vol. iii, p. 361. 


holes have been made in the artificial teeth and also in the natural 
ones next to them, one applies the artificial teeth in the existing void 
and fixes them as neatly as possible with a silver wire by the help of 

It would appear that the author is here describing a prosthetic method, 
which he had never practised himself; and this results from the fact of 
his advising the perforation of the natural teeth for the passage of the silver 
wire destined to keep the prosthetic piece in its place. Evidently desiring 
to describe the mode practised by the specialists of those days for fixing 
artificial teeth, he erroneously imagines that the metal thread was passed 
through the holes drilled in the natural teeth; this would have been impos- 
sible, first, because of the atrocious pain due to the sensibility of the 
dentine and of the dental pulp, and then because of the pathological 
consequences to which the perforation of the teeth would have given rise. 
We may, therefore, surely hold that Purmann is simply describing, and 
not even accurately, a prosthetic method already in use among the 
specialists of that period. 

On examination of the passage cited above — which, however, is not 
so clear as might be desired — it would appear that the models of which 
the author speaks were most probably quite different from those in use 
now. It is almost certain that the specialists of those days first made a 
sketch of the prosthetic part to be constructed, using for the purpose 
a piece of wax which they partly modelled with the hand and partly 
carved; and after having tried on this model until it fitted perfectly in 
the mouth, and was in every way satisfactory, they probably passed 
it on to a craftsman to make an exact reproduction of it in bone or 

In the year 1632 a little book was published in Naples, having for its 
title, Nuova et utilissima prattica di tutto quello cWal diligente Bar- 
biero s'appartiene; composta per Cintio d^Amato,^ This pamphlet was 
reprinted in Venice in 1669, and again in Naples in 1671. We here 
make mention of it, not for any special importance which it really has as 
regards the development of the dental art, but because of its being most 
probably the first book in the Italian language in which dental matters 
are spoken of independently of general medicine and surgery. 

ToMMASO Antonio Riccio. The edition of 1671 was published 
under the supervision of Tommaso Antonio Riccio, who was for many 
years a disciple of Cintio d'Amato, and who greatly eulogizes his master 
and praises his work. He expresses himself in the following bombastic 

* Purmann's Wundarzenei, Halberstadt, 1684, Part I, chap, xxxii. 

^ New and very useful practice of all that which belongs to the diligent barber; composed 
by Cintio d 'Am a to. 


manner: "This book, the offspring of Master Cintio d'Amato, excellent 
in the Barber's Art, ought to find a place in the bosom of Eternity; because 
by reason of its having been twice given to the light, it has proved its 
worthiness to live forever in the memory of men, gaining for itself, by 
its excellence, immortal glory before all such as are practised in the 

The book — which consists of about one hundred and eighty pages, 
and is illustrated by several admirable engravings — contains, among 
other things, two pages of verses, written by various authors, viz., by 
Cintio d'Amato himself, by Giovan Battista Bergazzano, also a barber, 
and by others. The greater part of these verses are in praise of the 
two doctors and Martyrs in Christy Cosmos and DamianuSy special pro- 
tectors of the Art and of the author. 

The verses of Cintio d'Amato reveal the possession of a literary and 
poetic culture above the ordinary, in spite of his being only a master 
barber. As to his book, it may be considered, for the time in which it 
was written, as an excellent treatise on so-called minor surgery. The 
author expounds, in a few chapters, the anatomical notions relating to 
bleeding; speaks at great length of this operation and of everything 
concerning it; refers with much detail to all pertaining to the use of leeches, 
cupping, scarification, cauteries, issues, blistering, primary treatment of 
the wounded, nursing of the sick, etc.; at the end of the book there is 
also a long chapter on the embalming of corpses. 

As regards the treatment of the teeth and gums the author dedicates 
six chapters thereto, entitled, respectively: "On the relaxation of the 
gums" (Chapter XXXVII); "Preparation for strengthening the gums 
and making the teeth firm" (Chapter XXXVIII); "On tartar and 
spots on the teeth" (Chapter XXXIX); "Another preparation for 
whitening and preserving the teeth" (Chapter XL); "Mode of burn- 
ing hart's horn, very necessary in preparations for the teeth" (Chapter 
XLVII). " *Water of salt,' which makes the teeth white and is also 
good for ulcers of the gums" (Chapter XLIX). 

Evidently Cintio d'Amato treats of dental matters only within extremely 
restricted limits. He tells us nothing with regard to the treatment of 
toothache, nothing about caries, about prosthesis, and, what is still more 
remarkable, he does not allude even in passing to the extraction of teeth. 
Now, if in a book treating of all that which appertains to the diligent barbery 
the most important dental subjects are passed over in silence, this shows 
that, contrary to the generally diffused opinion of today, the dental art 
was not at that time (at least not in Italy) exclusively, or even in great 
part, in the hands of the barber. Even at that time there must have 
been dental specialists, and the proof of this may be found in d'Amato's 
book itself, in the chapter entitled "Necessity and Origin of the Barber's 


Art."* The author, after having spoken of the divisions which the 
practice of the medical art had undergone from the most remote times, 
and after having alluded to the great number of parts into which Medicine 
was divided in the time of Galen, adds: "Which may also be seen in 
our own times, for as many as are the members of the human body, so 
many are nowadays the various kinds of doctors and of medicines. 
Some are for the teeth, some are for the ears, some for sexual maladies, 
others are ordinary doctors, others cure cataracts, others ruptures and 
stone, some make new ears, lips, noses, and others remedy harelips." 

As, under the generic name of doctors, Cintio d'Amato also comprises 
surgeons, it results from the above passage that in his time, that is, in 
the seventeenth century, there were surgeons who dedicated themselves 
specially to the treatment of the teeth; there were, in fact, dentists; and 
even admitting that the greater number of these were no better than 
simple tooth-pullers, this cannot be true of them all indiscriminately. 
Cintio d'Amato's book demonstrates in the most vivid manner that even 
among the barber and phlebotomist class, that is, among the practitioners 
of minor surgery, there were, at that time, men of considerable culture. 
This ought to hold good with still greater reason concerning surgeons, 
whose professional level was certainly superior to that of barbers;' and 
as dentists belonged to the class of surgeons (whence the denomination 
still in use of "surgeon-dentist"), it is but natural to admit that besides 
the ignorant tooth-puller there were even then more or less cultured 
dentists well capable of treating dental diseases and performing dental 
operations within the limits permitted by the knowledge of the times. 

The six chapters in which Cintio d'Amato speaks of matters referring 
to the teeth do not contain anything whatever of real importance; not- 
withstanding this, we will here refer to the beginning of Chapter XXXIX, 
treating "Of tartar and spots on the teeth," because it is of some his- 
torical interest: 

* The art of beautifying the human body was comprised by the ancients among the many 
and various parts of the medical art, under the name of decorative mediiine. The barbers 
considered themselves members of the medical class, as practitioners of decorative medicine 
and in a certain degree also of surgery. 

^ In a chapter entitled **Of the Kxcellence and Nobility of the Barber's Office," Cintio 
d'Amato speaks of several barbers of that period, who were in great repute by their writings, 
or by the high offices with which they were invested, or by honors received from princes and 
sovereigns. Among the writers, Tiberio Malfi, barber of Montesarchio, deserves mention; 
he published, in 1626, a book entitled The Barber, written in excellent style, and giving 
proof of solid literary culture, and of much erudition. This work treats of all that 
concerns the barber's art (decorative medicine, bleeding, etc.). In it, however, there is 
absolutely nothing about the treatment of the teeth or their extraction; and this constitutes 
a valid confirmation of our own opinion, that is, that the dental art was not at that time in 
any way in the hands of the barbers. 


" It happens in general that owing to vapors that rise from the stomach, 
a certain deposit is formed on the teeth, which may be perceived by 
rubbing them with a rough cloth on waking. One ought, therefore, to 
rub and clean them every morning, for, if one is not aware of this, or 
considers it of little account, the teeth become discolored and covered 
with a thick tartar, which often causes them to decay and to fall out. 
It is then necessary that the diligent barber should remove the said tartar 
with the instruments destined for this purpose." 

We have seen that the practice of the dental art was for the most part 
in other hands than in the barber's. Nevertheless, the important opera- 
tion of the removal of tartar was also carried out by him. If, therefore, 
even the barbers, who were not in the least the true representatives of the 
dental art of that period, carried out such an important operation, it may 
logically be argued from this, in support of what we have said before, 
that the sphere of action of the true dental specialists of those times 
(especially of the best among them) was not at all so limited as imagined 
by those who affirm that in past times dentists properly so called did not 
exist, but only tooth-pullers. 

The barbers, however, having become, in a certain manner, members 
of the medical class, sought to extend their sphere of action, and it is 
probable that in a later period than that of Tiberio Malfi and Cintio 
d'Amato they invaded the whole field of dental activity; for which reason, 
when the barber's art came down to a very low level, the dental art must 
have degenerated, too, and have been represented for a certain time only 
by ignorant barbers and tooth-pullers. Vicissitudes similar to these 
have occurred in different epochs, not only in various parts of Italy, 
but also in other countries of Europe. 

Fleurimond. In 1682 a little book on dental hygiene was published 
in Paris by a certain Fleurimond, the title of which was: Moyens de 
conserver les dents belles et bonnes. Portal, in his history of anatomy 
and surgery, makes mention of this pamphlet, and, briefly alluding to 
certain parts of it, he says: "The author proves by observation that 
acids act upon the enamel of the teeth. He makes some very just reflec- 
tions upon dentition. Fleurimond speaks of a tooth powder invented by 
him, but does not say how compounded."* 

In fact, it seems that this pamphlet was compiled from a commercial 
point of view, viz., that of making known the special tooth powder invented 
by the author. The era of advertisement had already begun! 

Anton Nuck (1650 to 1692), a Dutch surgeon and anatomist, who 
taught most ably in the University of Leyden, devoted great attention 
to dental surgery and prosthesis. Relative to the extraction of teeth, he 

* Portal, vol. iii, p. 618. 


says that, in order to be able to carry out this most important operation, 
an exact anatomical knowledge of the alveoli and of the teeth themselves 
is required. He insists on a principle of capital importance that has 
only had its full application in the nineteenth century, viz., that the 
instruments to be used for the extraction of teeth ought to vary according 
to the tooth to be extracted. For the removal of the incisors, he says, 
the "goat's foot" should have the preference; the canines ought to be 
extracted with the common dental forceps, but sometimes, when they 
are decayed, they may be extracted with greater security with the pelican; 
for the small molars the straight-branched pelican is to be preferred, 
for the large molars the curved pelican; as to the extraction of roots 
or of splinters of bone, this ought to be carried out with the rostrum 

The author counsels never to extract teeth during pregnancy, except 
under circumstances of the greatest urgency, and especially to avoid the 
extracting of the upper canines (or eye teeth), this being capable of pro- 
ducing pernicious effect on the visual organs of the fetus! 

The best way of obtaining the cessation of a violent toothache without 
having recourse to extraction is, according to the author, cauterization of 
the antitragus, an operation which he carried out with a special cauter- 
izing instrument, made to pass through a small tube, the better to localize 
and to limit the action of the red-hot iron. With regard to this means of 
cure already recommended by other authors, we may remark that, although 
it seems ridiculous at first sight, and although no one could be so sense- 
less as to make use of it in our days, nevertheless, for the times of which 
we are writing, when the curing of toothache was in a great measure 
effected by indirect means, this remedy might well stand on a level with 
many others, and was not perhaps altogether inefficacious. It is a suffi- 
ciently well-known physiological fact that the application of a strong 
stimulus in one part of the body may diminish or suppress a painful 
sensation in another part of the organism. It is an equally well-known 
fact that it is in no way a matter of indifference, in producing this phe- 
nomenon, to what part the stimulus be applied, especially because of the 
great difference existing in the relations of the several parts of the body 
with the brain — the centre of sensation. It is, therefore, very possible 
that the cauterization of the antitragus may really have the effect of 
causing strong toothache to cease, at least temporarily. 

Nuck used a variety of remedies to arrest dental hemorrhage, such as 
tinder, burnt linen, vitriol, sulphuric acid and the cauterizing iron. 

As to the use of the file, far from rejecting it entirely, as does Martin, 
he holds it necessary in many cases for planing down points and sharp 
edges of broken teeth, as well as for removing, at least in a measure, 
the inconvenience and deformed appearance caused by irregular teeth. 


He says the file may be used without causing the slightest harm, if one 
takes care not to approach the inner cavity of the tooth too nearly, and 
above all not to penetrate right to it, which would give rise to intolerable 
pain. Such an accident, he adds, may happen much more easily when, 
instead of using the file, whole pieces of teeth are removed with the 
excising forceps. 

This author acquaints us with a tooth powder, much used in his time, 
especially by Parisian ladies. The ingredients were powdered cuttle 
fish, coral powder, cream of tartar, Armenian bole, and powder of 
red roses. 

At that time artificial teeth were generally made of ivory; Nuck, how- 
ever, observes that it soon becomes yellow by the action of food and 
drink, and of the saliva itself. He therefore recommends, instead, the 
use of hippopotamus' tusks, giving the preference to the whitest. Ac- 
cording to Nuck, artificial teeth made of hippopotamus' tusks would be 
capable of preserving their color even for seventy years. In the case of 
all the teeth of the lower jaw being wanting, the entire dental arch ought 
to be framed in with a single piece of ivory or tusk of hippopotamus.^ 

Carlo Musitano, a celebrated Neapolitan doctor (1635 to 17 14). 
According to Carlo Musitano, the real cause of toothache consists in 
the irritant action of saline or acid particles on the extremely thin mem- 
brane that lines the alveoli or on the exquisitely sensitive nerves of the 
teeth. As he believes, these particles have an angular form, sometimes 
pointed or even hoo]|ed, and they reach the sensitive parts either directly 
from the outside, tl>rough the air, the food or drink (especially when the 
teeth are already decayed), or else through the blood and other humors, 
which often, by reason of their deteriorated quality, contain great quan- 
tities of such irritant particles. 

Among the various influences which may be conducive to toothache, 
atmospheric conditions ought also to be included; thus, says the author, 
the inhabitants of the Baltic littorals, and other northern peoples, are very 
subject to toothache, for the reason that in those regions the air contains, 
in abundance, saline particles of various kinds which penetrate into the 
organism by the act of respiration. It is said, on the contrary, that in 
Egypt, where the air is remarkably mild, the teeth are not subject either 
to pain or to decay. 

Musitano, too, believes in worms in the teeth, but does not admit, 
as preceding authors had done, that they generate spontaneously. He 
holds instead that they result from the eggs of flies and other insects, 
which, together with food, are introduced into the carious cavities and 
there develop by the heat of the mouth. 

* Antonii Nuck operationes et experimenta chirurgica, Lugduni Batavorum, 1692. 


The treatment of toothache ought to diflFer according to its causes. 
If the pain be owing to acidity, one uses medicines adapted for tempering 
the acids; if it be owing to the action of saline substances, one has recourse 
to remedies which dissolve them; if to worms, to such remedies as destroy 
them, and so on. Purgatives and bleeding ought, however, never to be 
used as remedies against toothache; for, far from doing good, they often 
do harm. As to the other torments usually inflicted on poor sufFerers, 
they are the punishment of their sins, for God often gives the unrighteous 
into the hands of doctors ! (This language will perhaps appear less 
strange when the reader comes to know that Carlo Musitano was at one 
and the same time priest and physician!) 

After a lengthy enumeration of medicaments to be used against tooth- 
ache, which we pass over in silence because already known, the author 
speaks of two remedies which carry us back absolutely to the days of 
Pliny! He relates us a fact experienced by himself, that, by touching 
an aching tooth with the leg of a frog completely cleaned of the flesh, 
the pain ceases altogether. Also, if the aching tooth be touched with the 
root of a tooth extracted from the jaw of a corpse, the pain ceases, the 
tooth becomes as cold as ice, and often, after a certain time, it falls to 

As to worms, the best mode of destroying them is by using bitter sub- 
stances, such as myrrh, aloes, colocynth, ceniaurea minory etc., but some- 
times the use of sweet substances, such as honey, is a good means of 
drawing them out of the carious cavities! 

Musitano also cites a great number of remedies against the setting on 
edge of the teeth. Among the best of these he mentions urine applied to 
the teeth whilst still warm! Alkali in general, and particularly lye, 
such as is used for washing purposes, are good remedies against the 
setting on edge of the teeth. 

The treatment of loose teeth ought to vary according to whether this 
pathological condition depends on old age, or on scurvy, on syphilis, 
on superabundance of humors, etc. Sometimes, especially in old persons, 
it may be useful to bind the teeth with gold wire, in order to prevent their 
falling out, but this operation must be very ably performed, otherwise it 
may give rise to inflammation. 

Relative to artificial teeth, Musitano says that they are made of ivory 
or hippopotamus tusks; of these last he does not speak as of a novelty; 
we may, therefore, deem it probable that hippopotamus tusks were used 
in Naples for making artificial teeth even before the Dutchman Anton 
Nuck (contemporary of Musitano) made mention of them in his writings. 

In cases of difficult dentition, the best remedy, according to Musitano, 
for facilitating the eruption of the teeth consists in friction of the gums, 
once, or at most twice, with blood drawn fresh from the comb of a cock! 


If, however, even this remedy fails to produce the desired effect, it will 
then be necessary to lance the gum at the point where the tooth is to erupt, 
or to press it hard with the thumb, that the tooth may the easier come 

The sole merit of this author (as to what concerns our specialty) 
consists in his having declared bleeding useless, or even harmful in the 
treatment of toothache, and, besides, in his having recommended, with 
great warmth and in most impressive terms, cleanliness of the teeth. 
What is more beautiful, says he, than a mouth furnished with white teeth, 
similar to so many pearls? And what is more abominable than black 
or livid teeth, covered with a fetid deposit or with tartar? Unclean teeth 
spoil the appearance of the person, and nauseate those who behold 

William Cowper (1666 to 1709). Toward the end of the seventeenth 
century the celebrated English doctor and anatomist, William Cowper, 
opened up a new field of action to oral surgery by inaugurating the 
rational treatment of the diseases of the maxillary sinus. In order to 
empty Highmore's antrum of deposits and to be able to carry out the 
necessary irrigations, he extracted in most cases the first permanent 
molar, and then penetrated through its alveolus into the sinus with a 
pointed instrument. 

James Drake, also an Englishman and a contemporary of Cowper, 
operated in the same manner; and it was this author who made known 
in a book of his^ the operative method of Cowper; for which reason 
the above-mentioned proceeding is sometimes called "the Cowper- 
Drake operation.'* A certain time elapsed, however, before it became 
generally known. Thus, in a book published by Johann Hoffmann 
in 1 7 13 there is no mention made of this operation, albeit the author 
refers therein' to the case of a young girl, one of whose canine teeth having 
been extracted by him, there ensued a considerable flow of whitish pus 
from the maxillary sinus. In speaking of this case, Hoffmann stigmatizes 
many of the surgeons of his time who were not acquainted with the 
existence of Highmore's antrum, and therefore, in cases of patients whose 
teeth had fallen out as an effect of syphilis, if they happened to penetrate 
with the sound into the maxillary sinus, believed this to be an accidental 
excavation of the bone, produced by caries. 

However, the honor of having initiated the rational treatment of dis- 
eases of the maxillary sinus is not exclusively due to William Cowper 
and to James Drake; a large share is also due to the celebrated German 

^ Caroli Musitani opera omnia, pp. 121 to 128, Venetiis, 1738. 

^ J. Drake, Anthropologia nova, London, 1707. 

'J. M. Hoffmann, Disquisitiones anatomico-pathologicae, Altorf, 1713, p. 321. 


physician and anatomist, Heinrich Meibom. The mucous membrane of 
the maxillary sinus was considered by him as the real point of departure 
of the diseases which occur in this cavity, it being liable to become 
inflamed and to suppurate, thus giving rise to much pain and to various 
accidents. Meibom rejects the operation of Molinetti, that is, the tre- 
panning of the cavity from the front, the lesion produced in the soft parts 
of the face being likely to give rise to unpleasant consequences. "Some, 
he adds, try the introduction of medicated vapors into the antrum,* 
but the best way is to open the maxillary sinus by extracting a toothy 
as the pus generally makes its way as far as the roots of the teeth,*'^ The 
author says that his father, who was also a physician, had already used 
the above method with success. He does not speak at all of the artificial 
opening of the antrum by perforation; but, as is well known, this is not 
necessary in many cases, so that, even now, the operation is sometimes 
reduced to procuring the opening of the sinus by the simple extraction of 
a tooth, as was, in fact, practised by Heinrich Meibom and his father. 

Seeing that Heinrich Meibom was born twenty-eight years before 
William Cowper, and was already known to the scientific world when 
Cowper was still a child, it is very probable that his operative method, 
having come to the knowledge of the latter, was only followed up and 
perfected by him. 

Charles St. Yves (1667 to 1733), oculist in Paris, records an interest- 
ing case of a secondary afl^ection of the maxillary sinus. The point of 
departure of the evil was an abscess in the orbit. The suppurative 
process, after having produced an erosion and the perforation of the 
orbital plane, had reached by propagation the antrum of Highmore, 
whence the pus took its way, issuing through the nose. St. Yves had a 
molar tooth extracted on the afl^ected side (we do not know which side 
it was), after which, day by day, he made injections of detersive liquids 
through the orbital fistula, which returned constantly through the 
alveolus of the extracted tooth. By this means the cure of the patient 
was obtained.' 

Christopher Schelhammer (1649 to 17 16), who was professor in 
various German universities, and distinguished himself specially as an 
anatomist and as an ear doctor, strongly recommends stopping decayed 
teeth as the best means of causing pain to cease. If, however, the stop- 
ping does not hold, by reason of the cavity being too extended, it is then 
necessary, says Schelhammer, to extract the tooth; this, however, may 

* Probably through the nose. 

* H. Meibomii de abscessum internorma natura et constitutione discursus. Dresdx et 
Lipsise, 1718, p. 114. (This edition was published after the author's death, which took 
place in 1700.) 

^ St. Yves, Nouveau traite des maladies desyeux, 1722, p. 80. 


very well be stopped after extraction, and then replanted, for it will take 
root again, but no longer be the cause of any pain/ 

Pierre Dionis, a celebrated surgeon and anatomist of Paris (died 
1 718), in his Anatomie de rhommey^ admits the possibility of a double 
dental series, holding the case, however, to be of very rare occurrence. 

Another work of his, entitled Cours d^operations de Chirurgiey wherein 
he treats very extensively of diseases of the teeth and mouth, and their 
surgical cure, is of much more importance in relation to dentistry. He 
recognizes the high importance of this part of surgery, but expresses the 
opinion that one of the dental operations, that is the extraction of teeth, 
ought to be left entirely to the tooth-pullers, not only because they are, 
by reason of great practice, better qualified to perform it than general 
surgeons, but also because the output of force required for this tooth- 
pulling operation renders the hand heavy and tremulous, and, lastly, 
because, according to him, it always has something of charlatanism 
about it. (This is a luminous example of how preconceived ideas can 
influence the minds even of men of the greatest talent.) 

Pierre Dionis, like many of the preceding authors, had frequently 
occasion to observe cases of epulis. He speaks at great length of the 
treatment of this afl^ection, as well as of parulis, but says nothing on the 
subject of sufficient importance to be worth recording. 

Dental operations, according to Dionis, are of seven kinds: 

1. The opening of the dental arches in the case of spasmodic constriction 
of the jaws. This operation, of the greatest importance for nourishing 
and keeping patients alive, is carried out by means of a lever and of a 
screw dilator. 

2. The cleaning of the teeth. For this, as for the other operations, 
says Dionis, a certain amount of skill is required. The author advises 
the use of gold instruments if one be called upon to clean the teeth of 
persons of rank. This appears rather strange in the present levelling 
times, but Pierre Dionis lived in the days of Louis XIV, whose doctor he 
was, that is, in a period of unbridled luxury, when the nobles and those 
in power would have nothing in common with the lower classes. 

3. Operations for the preservation of the teeth. These, says Dionis, 
are of the greatest importance, it being necessary to oppose a barrier to 
the destructive processes of the teeth. Caries, when so situated as to 
permit of it, ought to be scraped away; for approximal caries one ought to 
have recourse to the file; in the case of caries of the triturating surfaces, 
cauterization should be used, by applying a drop of oil of vitriol with a 
miniature paint brush. Should the caries, however, be in a very advanced 

* Sprengel, Geschichte der Chirurgie, vol. ii, p. 301. Carabelli, Systtmatisches, Handbuch 
der Zahnheilkunde, vol. i, p. 60. 
^ This work was published in 1690. 


stage, it is better to make use of the cauterizing iron. But in cases of 
intense and persistent pain there is no other remedy than extraction. 

4. Stopping of the carious cavity. Dionis does not enumerate this 
operation among those intended for the preservation of the teeth. At 
that period, this operation was performed solely with a view to pre- 
venting the penetration into and the retention within the carious cavity 
of alimentary substances, and the disadvantages caused thereby. The 
carious process, says the author, often ceases altogether, and the pain then 
generally ceases also. However, as the residual cavity often becomes 
troublesome in various ways, among others by making the breath oflFensive, 
it is better to stop it. For this purpose, gold or silver leaf is generally 
made use of; but this mode of stopping is not durable, because gold or 
silver in leaf is apt to become loosened and fall out. It is therefore pre- 
ferable, says Dionis, to make a stopping with a piece of gold or silver 
corresponding in size and shape to the cavity.^ Many, he adds, prefer 
lead as a stopping, on account of its softness, whilst others simply 
use wax. 

5. The use of the file. The indications given by Pierre Dionis for using 
the file do not differ from those we find in other authors. Dionis warns, 
however, against using the file to level down a tooth which has become 
lengthened through the loss of its antagonist, for after a certain time it 
would again project above the level of the others. 

6. Extraction. This operation, says Dionis, ought not to be performed 
too lightly, but only in those cases in which it is really necessary; that is, 
when a tooth is the cause of insupportable pain and its crown is almost 
entirely worn away; when nothing remains of a tooth but its root; when a 
tooth is so loosened in its socket as to leave no hope of its again becoming 
firm; when supernumerary teeth or irregularly planted teeth give rise to 
inconvenience or deformity; and lastly, to remove deciduous teeth that 
have become loosened. The opinion that if the loosened milk teeth be 
not promptly extracted they cause the permanent teeth to grow irregularly, 
is, however, considered by Dionis to be a prejudice. 

Dionis strongly doubts whether a tooth that has been extracted and 
replanted can really take root again, as had been affirmed by Dupont, 
Pomaret, and other authors. This shows that Dionis had had no expe- 
rience on this point. 

7. The application of artificial teeth. These teeth, says Dionis, are 
generally made of ivory, but may also be made of ox bone, which is less 
liable to turn yellow than ivory. He does not mention the use of hippo- 
potamus tusks, but we learn from him that one Guillemeau made arti- 

' Here one also verifies the absurdities pronounced by those who, not being dentists, but 
merely general practitioners or surgeons, still risk speaking on dental subjects. 


ficial teeth with a composition of his own invention, which was obtained 
by fusing together white wax and a small quantity of gum elemi, and then 
adding ground mastic, powder of white coral and of pearls. This fact is, as 
everyone can see, most important, for it constitutes the first step toward 
the manufacture and use of mineral teeth. Dionis tells us that the teeth 
made of Guillemeau's composition never became yellow, and that it was 
also very good for stopping decayed teeth. ^ It would seem, therefore, 
that it could be used as cement is now used. 

The Guillemeau of whom Dionis speaks is probably Jacques Guille- 
meau, the author of a book now no longer to be found, which was trans- 
lated from the French, first into Dutch, and afterward into German. 
Crowley, in his Dental Bibliography^ only quotes the German edition, 
published at Dresden in 1710, the title of which runs thus: Der 
aufrichtige Augen und Zahnarzt^ 

Jean Verduc, also a Frenchman, relates a case of the surgeon Car- 
meline,' analogous to that of Denis Pomaret, in which a sound tooth 
which had been extracted by mistake was immediately replanted and 
took root again, becoming quite firm. However, Verduc does not speak 
of replantation as a special method of cure, but merely refers to the above 
case incidentally in speaking of the extraction of teeth. He considers this 
operation a most dangerous one, and advises not having recourse to 
it except in cases of utmost necessity. Notwithstanding this, Verduc 
gives us to understand that teeth were drawn with sufficient ability by 
most of the operators of the time, and precisely because of this he omits 
describing the manner of performing the operation. According to Verduc, 
the drawing of teeth is often of little or no advantage against toothache.* 
In proof of this assertion he relates the case of a hypochondriac, who 
little by little had as many as eighteen teeth extracted, without, however, 
getting the better or the wiser; but as this case does not prove anything 
at all, one is disposed to think that Verduc, in relating it, had the intention 
of being humorous. 

Monsieur de Lavauguyon. To another French surgeon. Monsieur 
de Lavauguyon, also a contemporary of Dionis, belongs the merit of 
having declared useless, in the greater number of cases, the practice, at 
that time general, of separating the gums from the tooth before proceeding 

' Dionis, Cours d'operations de chirurgie, Paris, 1716, p. 507 and following. 

^[The Dresden edition of 1710 of Guillemeau's work contains no reference to the 
artificial tooth composition as mentioned by Dionis. — £. C. K.] 

^ Carmeline was a most able surgeon-dentist. We learn this from a passage in Pierre 
Fauchard's book (Le Chirurgien Dentiste, Pref., p. 13). As we shall see, the author praises 
him very highly and laments his not having written any book making known the results of 
his long experience. 

^ Sprengel, Geschichte der Chirurgie, vol. ii, p. 305. 


to the extraction of the latter. He says that this is only necessary when 
a tooth, either because broken or because its crown emerges too little 
above the gum, offers an insufficient hold for the pelican.* 

Our historical survey has now reached the end of the seventeenth 
century. Embracing at a glance the whole of this last period of time, 
we remark, among many facts of minor importance, some events which, 
in the history of the development of dental art, stand out in strong relief. 
Such are the replantation of teeth used as a special curative method by 
Dupont and others; the method of plugging in cases of alveolar hemor- 
rhage, the credit of which is due to Riviere and to Tulpius; the descrip- 
tion of the maxillary sinus given by Highmore; the rational treatment 
of affections of the antrum, inaugurated by Meibom, Cowper, and 
Drake; the researches into the microscopic structure of the teeth, bril- 
liantly initiated by Leeuwenhoek, who discovered the dentinal tubuli; 
the use of models introduced by Purmann into the workmanship of 
prosthetic pieces; the employment of hippopotamus' tusks in making 
artificial teeth, first recommended by Nuck; and the invention of Guille- 
meau, which was the first step toward the use of mineral teeth. 

* Traite complet de operations de chirurgie, par Mons. de Lavauguyon, Paris, 1696, p. 644. 


Although there have been, even from the most remote times, indi- 
viduals who have dedicated themselves exclusively to the cure of dental 
maladies, or to repairing the losses of the dental system by artificial 
means, and notwithstanding the progress gradually accomplished in this 
branch of the medical art, which progress was especially remarkable 
during the sixteenth and seventeenth centuries, it is not to be denied that, 
up to the beginning of the eighteenth century, dentistry was, in great part, 
considered one with medicine and surgery in general. It is but natural 
that dental art (and the same may be said of every special branch of 
medicine) could not assume a real individuality until it had attained to 
the higher grades of its development. As a matter of fact, dentistry, 
toward the end of the seventeenth century, was already a true specialty, 
although it counted but few worthy representatives at that time. The 
definite separation between the science and art of dentistry and general 
medicine and surgery, although it may have been retarded, could not fail 
to take place; and this, as we shall presently see, was eflFected by the 
celebrated French dentist Pierre Fauchard. 

But, to remain faithful to chronological order, we will first speak 
briefly of some other writers. 

LuDWiG Cron, a barber of Leipsic, in a pamphlet published in 17 17, 
with the title The barber s apprentice versed in bleeding and tooth pulltngy^ 
declares, in a still more emphatic and general way than De Lavauguyon, 
that it is useless to detach the gum before proceeding to extract a tooth. 
This barber, strong in his own experience, dares to assert absolutely use- 
less this ancient practice, advised first by Cornelius Celsus, and recom- 
mended after him, and in homage to his authority, by many other writers. 
It is, therefore, possible that even previous to Cron and De Lavauguyon 
many operators had dispensed with the practice recommended by Celsus, 
although this had become an accepted canon of the high medical pro- 

LoRENZ Heister (1683 to 1758), of Frankfort-am-Main, one of the 
most celebrated surgeons of the eighteenth century, wrote a dissertation 
on toothache,' treating besides very extensively of dental affections and 

' Der beym aderlassen und Zahn-ausziehen Geschickten Barbiergesell, Leipsic, 171 7. 
' De dentium dolore, Altdorf, 171 1. 


their cure in a masterly work on surgery, published for the first time in 
1 718, and which went through numerous editions in various languages. 

When the caries of a tooth is superficial, Heister advises the removal 
of the decayed part with the file; or, when the caries is deep down, 
the cavity ought first to be well cleaned with a toothpick or other like 
instrument, then filled with heated white wax, or mastic, the stopping 
being renewed as often as may be necessary. When a molar tooth is 
decayed, especially in the centre, the best way, says Heister, is to fill it 
with gold or lead leaf, or with a piece of the latter fitting into the cavity. 
If the carious cavity of a painful molar cannot be cleaned as it ought to be, 
the dropping of a little oil of cloves or of cinnamon or of guaiacum into 
it will be found useful, or even a few drops of spirit of vitriol; for in this 
manner one obtains at the same time the double advantage of destroying 
the impurities contained in the carious cavity and of soothing the pain. 
But if by chance the pain should persist, recourse must be had to the 
cauterizing iron, or to extraction. Sometimes, however, even the most 
violent toothache can be made to cease, either by scarifying the gums 
(a method already recommended by Pliny), by cauterizing the antitragus, 
or by pressing the aching tooth hard between the fingers, as Schelhammer* 
and some other writers had advised. 

Heister writes at length on the extraction of teeth, on the indications 
and counterindications appertaining thereto, on the instruments with 
which the operation should be carried out, and so on. Regarding the 
position of the patients, he thinks it best to place them on a low seat or 
on the ground, if the tooth to be extracted is situated in the lower jaw, 
but if an upper tooth is to be extracted, patients should be placed on a 
chair or on a bed. 

Movable prosthetic pieces are mentioned for the first time by this 
author. Although he is very concise in his manner of speaking of artificial 
teeth (this indicating that dental prosthesis was considered outside the 
sphere of action of the general surgeon), we nevertheless learn from him 
that partial sets of teeth made of ivory or hippopotamus tusks, and 
without special appliances for fixing them, were then in use, which, 
when applied in the void between the neighboring teeth, were maintained 
in position simply by their form. The author advises keeping prosthetic 
pieces very clean, removing them every evening before going to bed, and 
not putting them back in the mouth until they have been well cleaned. 

Heister also speaks of nasal prosthesis; this was then carried out by 
applying noses made of wood or of silver, properly painted. In cases of 

* Schelhammer wrote a dissertation "on the cure of toothache by touch/* De odontalgia 
tactu sananda, Kiel, 1701. In the same year and in the same city, another pamphlet, by 
B. Krysingius, was written on the same subject. (See Crowley, Dental Bibliography, p. 13.) 


trismus, this author altogether rejects the forcible opening of the jaws 
by means of screw dilators and such like instruments, as they act too 
violently, and, according to him, only aggravate the morbid condition. 
Even the extraction of a tooth is useless in such cases, as the patient 
can always absorb a certain quantity of liquid food through the closed 
teeth. On the other hand, the author expresses himself in favor of the 
incision of the gums in cases of difficult dentition. According to him, 
convulsions and the other nervous symptoms which children are subject to 
during the period of dentition depend wholly on the hardness and strained 
condition of the gum. It is, therefore, natural that the symptoms should 
disappear when an incision of the gums, reaching to the tooth that is 
coming through, has caused the tension to cease. 

The author speaks very particularly of the treatment of epulis and 
parulis; but his views on this subject contain nothing of great importance. 

Rene Jacques Croissant de Garengeot (1688 to 1759), the cele- 
brated French surgeon, speaks very little of dental surgery in his works. 
He declares himself averse to the carrying out of too many operations 
on the teeth, and especially disapproves the use of the file, because, ac- 
cording to him, it ruins the enamel.* For a long time, especially in France, 
Garengeot was believed to have been the inventor of the key known by 
his name; but he merely perfected this instrument. In fact, through a 
later author, Lecluse, it clearly results that the key existed before Garen- 
geot. " For extracting," writes Lecluse, "one may make use of the pelican 
that Garengeot has constructed on the English key." In a note, he after- 
ward adds, " that the English key is an instrument used by dentists in 
England." However, it is not in the least certain that the key is really 
an instrument of English origin. 

Loder, who wrote at the end of the eighteenth century, informs us that 
the so-called English key was called the German key in England; it is, 
therefore, not improbable, that this instrument, as some maintain, had 
its origin in Germany.^ 

JoHANN Junker (1679 to 1759), professor of medicine at the University 
of Halle, wrote on dental maladies, not only in a treatise on surgery, pub- 
lished in 1 72 1, but also in three dissertations which were published some 
time later, and were entitled respectively: De affectibus dentium (1740), 
De dentitione difficili (1745), De odontalgia (1746). The author, however, 
for the most part, only repeats things already known; his writings have, 
therefore, little or no importance for us. He counsels the Cowper-Drake 
operation in treating the affections of Highmore's antrum; in carrying 
out the operation, however, he thinks the extraction of the second molar 

' Sprengel, op. cit., vol. ii, p. 311. 

' Joseph Linderer, Handbuch der Zahnheilkunde, vol. ii, p. 129. 



to be preferable to that of the first. To prevent the formation of tartar 
on the teeth, he advises assiduous care in keeping the mouth clean, and 
recommends, among other things, rubbing the teeth with sage. He dis- 
approves having recourse too readily to metal instruments to remove 
tartar from the teeth, because, according to him, it favors the production 
of dental caries. He holds it dangerous to extract the upper or lower 
canines when they are not loose, as, by reason of the depth of their roots 
an injury to the surrounding nerves may be the result, which not only 
might cause great pain, but in the case of the upper canines might lead 
to inflammation of the eye, and even of the dura mater! 

When the caries is incipient. Junker advises rubbing the teeth several 
times a day for some time with common salt, in order that this should 
penetrate into their structure.* 

GuiLLAUME Maquest de LA MoTTE (1655 to 1 737), a distinguished 
French surgeon and the writer of an excellent treatise (Traite complet 
de chirurgiej Paris, 1722), repeats the advice already given by preceding 
authors, to which he annexes the highest importance, that is, the opening 
in time of abscesses of the gums and of the palate even before they be 
completely matured, in order to prevent the suppurative process from 
extending and damaging the bone below. This author relates having 
several times arrested serious hemorrhage following on the extraction of 
teeth, by applying a little vitriol inside the alveolus, and, on this, graduated 
compresses, which the patient pressed on the part with the teeth of the 
opposite jaw.' 

JoHANN Adolph Goritz, of Regensburg, in one of his writings pub- 
lished in 1725, disapproves the too frequent recurrence to extraction of 
the teeth, that is, carrying out the operation when it is not absolutely 
necessary. He is also averse to the application of artificial teeth. In 
support of his opinion he relates a case in which, a certain time after the 
application of an artificial tooth, the natural ones to which it had been 
fixed became loose, so that it was necessary to proceed to the fixing of all 
three, that is, the artificial tooth and the two neighboring ones, to the firm 
teeth beyond them; these, however, became loosened in their turn, and 
it was at last necessary to extract six teeth. The great space thus created 
was filled with a prosthetic piece made of hippopotamus tusk; but the 
author did not believe much good would come of this either. In fact, he 
is of opinion that the natural teeth should be preserved by every possible 
means, and that, on the other hand, even in the case of a few being lost, 
it is better not to resort to substitutes. In the worst case, should the 
dental void cause too great inconvenience by damaging the pronuncia- 

* Sprengel, op. cit., vol. ii, p. 367; Carabelli, op. cit. p. 65. 
^ Sprengel, op. cit., vol. ii, p. 310. 


tion, or for some other reason, it may be filled by an "imitation" in soft 

If one takes into consideration the by no means slight inconvenience 
to which fixed artificial teeth gave rise, one cannot but admit the aversion 
to them, expressed by Goritz and others, to have been justified. 

Ernst Ferdinand Gebauer, in 1726, made known a case in which, 
a tooth having been badly extracted by an incapable surgeon, the upper 
jaw was so seriously injured that a diffusive carious process ensued, 
which after many years' suffering brought the patient to the grave.' 

JoHANN Bernhardt Fischer (1685 to 1772), a very famous doctor, 
born in Liibeck, who had the honor of becoming archiater of the Russian 
Empire, related, in 1726, a case of replantation, similar to those by Pomaret 
and Carmeline; but Heinrich Bass (1690 to 1754), of Bremen, professor 
of anatomy and surgery in Halle, endeavored to demonstrate that in these 
cases the tooth did not really take root, but was rather maintained in 
position by the contracting of the surrounding gum. One perceives 
from this that there were still, at that time, discordant opinions on the 
subject of replantation, and that this operation was far from occupying, 
in dental surgery, the accredited position it has acquired today. 

Heinrich Bass also combats the abuse of extracting teeth inconsider- 
ately, without absolute necessity, and expresses the opinion that this 
is especially blamable in the case of teeth of the upper jaw, principally 
because the extraction of either the canine or of the first or second large 
upper molars might easily produce the opening of Highmore's antrum, 
and thus give rise to regrettable accidents. He is not, however, averse, 
like Goritz, to the use of artificial teeth; indeed, he advises the application 
of whole dental sets, even in the upper jaw, so long as there be two natural 
teeth existing to fix the prosthetic piece to.' 

Pierre Fauchard, the founder of modern scientific dentistry, was born 
in Brittany about the year 1690, and died at Paris in the year 1761. His 
celebrated work, Le Chirurgien Dentistey was already written in the year 
1723, but not published until 1728. It marks a new epoch in the history 
of dental art. The most renowned physicians, surgeons, and anatomists 
of the time testified their admiration for Fauchard's work, which was 
translated into German in 1733, and afterward went through two French 
editions in the years 1746 and 1786.* We have been able to obtain the 

* Sprengel, op. cit., vol. ii, p. 309. ' Sprengel, loc. cit. 
' Sprengel, op. cit., vol. ii, p. 310. 

* Le Chirurgien Dentiste ou Traite des Dents, ou Ton enseigne les moyens de les entretenir 
propres & saines, de les embellir, d'en reparer la perte & de remedier a leurs maladies, a 
celles des Gencives &c aux accidens qui peuvent survenir aux autres parties voisines des 
Dents. Avecdes Observations & des Reflexions sur plusieurs cas singuliers. Ouvrage enrichi 
dequarante-deux Planchesen taille douce. Par Pierre Fauchard, Chirurgien Dentiste a Paris. 


second edition* of this most important treatise, and of this we now intend 
making use for accurately analyzing the work, as it is probably more 
complete than the first, whilst the third, having been published after the 
author's death, is probably merely a reprint. 

The work consists of two volumes in duodecimo, in all 863 pages. In 
the beginning there is the portrait of the author and a long and interesting 
preface. The portrait, which we here reproduce, has also its historical 
importance, and this for two reasons, the first of which being that in it 
Fauchard is revealed to us as a person of very distinguished appearance, 
and this gives us an idea of the social condition of the surgeon dentists 
of his time; the second, because there are annexed to the portrait the 
following Latin verses, by a certain Moraine, in which, whilst eulogizing 
the writings of the author and his ability in the treatment of the teeth, 
and in restoring force and beauty to them, he counsels him "to despise 
the tooth of envy," as it will certainly break against his merit. 

Dum dextra et scriptis solamina dentibus affers 
Illorum in tuto sunt decor atque salus. 
Invidiam spemas igitur, Faucharde, cruentos 
Dentes; nam virtus frangere novit eos. 

That Fauchard, in common with all men of rare merit, had to combat 
all his life against envy, we are able to perceive from what we read at 
the end of the second volume of his work. The author here says that 
"the rumor having been falsely set about that he has abandoned the pro- 
fession; which rumor cannot have been invented otherwise than by those 
individuals who, sacrificing honor to interest, would attract to themselves 
the persons who honor the author with their confidence; he therefore 
finds it necessary to give warning that he still continues the practice of 
his art in Paris, in the Rue de la Comedie Fran(aisey together with his 
brother-in-law and sole student, M. Duchemin." 

More than a century and a half has passed by since Fauchard was 
obliged to defend himself against lies invented and set about to his damage 
by envious colleagues, but even at the present day, when, given the high 
grade that civilization has reached, and professional competition ought not 
to make use of other weapons than intelligence, study, and application, 
some do not hesitate to have recourse to means equally disloyal, ignoble, 
and shameless as those practised by some contemptible dentists of the 
middle of the eighteenth century. 

The preface of Fauchard's book is especially important for the notices 
therein contained regarding the author, as well as the conditions of dental 
art at that period. And first of all, we find in it the proof of what we have 
already said elsewhere, namely, that even before Fauchard, there were not 

* Deuxieme edition revue, corrige et considerablement augmentee, a Paris, 1746. 


only tooth-pullers but also dentists properly so called. Indeed, Fauchard 
makes mention also of the examination that aspirant dentists had to 
undergo as far back as the year 1700. It may interest our readers if 
we here give in detail some extracts in which the author speaks on these 

"Although surgery in general," says Fauchard, "has been greatly per- 
fected in these latter times; although important discoveries have been 
made in anatomy and in the modes of operating, and many learned 
and interesting observations have been published, nevertheless, dentists 
nowhere find in works on surgery sufficient aids to guide them in all 
their operations." These last words should be sufficient alone to prove 
that the dentists spoken of by Fauchard were not mere tooth-pullers. 

"The authors who have written on anatomy, on surgical diseases and 
operations, have only treated very superficially the part relating to maladies 
of the mouth and teeth. If some writers have spoken in particular about 
the teeth and their diseases, as, for instance, Urbain Hemard and B. 
Martin, they have not done so in a sufficiently ample manner. 

" Besides, there does not exist any public or private course of surgery 
in which the theory of dental maladies is amply taught and in which one 
can receive fundamental instruction in this art, so necessary for the healing 
of these maladies and of those of the neighboring parts. 

"This branch of the art having been but little cultivated, if not wholly 
abandoned by the most celebrated surgeons, their negligence has caused 
it to fall into the hands of persons without theory and without experience, 
who practise it in a haphazard fashion, guided neither by principles nor 
method. In Paris, it is only since 1700 that people's eyes have become 
opened to this abuse. 

"In this town, those who intend to become dentists are now obliged 
to undergo an examination, but although the examiners be most learned 
and well versed in all the other parts of surgery, I think, if I may be 
allowed to express my opinion, that as they do not ordinarily them- 
selves practise dental surgery, it would not be amiss on these occasions 
to admit an able and experienced dentist, who might sound the aspirant 
as to the difficulties which have come before him in the course of the long 
practice of his art, and who could communicate to them the means of 
surmounting them. In this way one would not have to acknowledge that 
the attainment of the greater part of dental experts* is below mediocrity. 

"To supply this want of instruction it would have been of great use 
if some able dentist, for example the late Monsieur Carmeliney who, in 
his day, practised with general applause, had made us acquainted with 

* Experts pour les Dents. This was probably the title which was bestowed in the relative 
diploma on those who passed the examination in question. 


his mode of operating and with the knowledge acquired through the 
successful treatment of a great number of important cases. 

"What this celebrated surgeon-dentist has not done, I today dare to 
undertake. I shall at least afford an example of what he might have done 
with greater erudition and better success. 

"From my youth I was destined to the surgical profession; the other 
arts I have practised* have never made me lose sight of it. I was the 
disciple of Alexandre Poteleret, surgeon-in-chief to His Majesty's ships, 
who had great experience in diseases of the mouth. To him I owe the 
first rudiments of the knowledge I have acquired in the surgical speciality 
I practise, and the progress I made under this able man gave me the 
emulation that has led me to further important discoveries. I have 
collected among different writers what seemed to me most reliable. 
I have frequently discussed these matters with the ablest surgeons and 
doctors of my acquaintance, and have neglected nothing in order to profit 
by their counsels and by their ideas. 

"The experience which I have acquired during an uninterrupted prac- 
tice of more than forty years has led me insensibly to the acquirement of 
further knowledge and to the modification of what seemed to me defective 
in my earlier ideas. I offer to the public the results of my labors and of 
my studies, hoping that they may be of some use to those who wish to 
exercise the profession of surgeon dentist." 

The reason why dentists before the time of Fauchard published hardly 
anything concerning their art, was perhaps out of a sentiment of jealousy, 
which rendered them (that is, the best of the profession and therefore the 
ones most capable of writing) but little disposed to make known to others 
the results of their studies and of their experience, lest the fruits of their 
long labors should be utilized by others and they themselves be materially 
damaged by competition. That this sentiment of jealous egotism 
really existed in many dentists may be, in a certain manner, deduced from 
a few words of Fauchard himself, who, although he has the very great 
merit of breaking with mean, old-world prejudices, nevertheless expresses 
the prevalent idea of the time, consisting in the belief that every arti- 
ficer, every inventor, had not only the right, but also the duty of surround- 
ing his discoveries with secrecy and mystery. These are the words in 
which, making known a certain improvement in dental prosthesis in- 
vented by him, he at the same time expressed his conviction that by so 
doing he is acting against his own interests: 

** I have perfected and also invented several artificial pieces both for 
substituting a part of the teeth and for remedying their entire loss, and 

' We have not been able to find any work in which particular records of Fauchard's life 
are given, and hence do not know to which of the other arts he had dedicated himself. 


these pieces substitute them so well that they serve perfectly for the same 
uses as the natural teeth. To the prejudice of my own interests I now 
give the most exact description possible of them." 

Now, although a man of elevated mind, such as Fauchard, may have 
been capable of sacrificing his material interests to higher aims, it is 
not, however, to be wondered at, taking also into consideration the lesser 
degree of culture and of professional ability of his predecessors, that none 
among them should have been found sufficiently disinterested to publish 
the results of their particular studies and experience, besides all those 
technical details which according to the ideas of that time constituted 
the secrets of the profession. 

In the course of this history, we have seen that the dental art was 
practised from the most remote times and in the most various countries, 
remaining, notwithstanding, for centuries in an embryonal condition. It 
was toward the end of the seventeenth and the beginning of the eighteenth 
century that, in the midst of the highly advanced civilization of the great 
French capital, it attained a high degree of development, entitling it to 
be considered a special branch of the medical art. 

It would, therefore, be wrong to believe that the dental art was created, 
for the most part, by Fauchard, and one clearly perceives, from the perusal 
of his work, that although he made most important contributions to this 
specialty, which he cultivated with passion, nevertheless, the greater 
part of the things therein treated of were already known before his time, 
although no reference to them is to be found in previous works; and this 
for the reasons we have already suggested. The highest merit of Fauchard 
consists, still more than in his inventions and improvements, in his having 
most ably collected and incorporated in a single work the whole doctrine 
of dental art, theoretical as well as practical, thus setting in full light the 
importance of the specialty, and giving it a solid scientific basis. 

France is therefore the first country where modern dentistry reached 
a high degree of development and also the first country where, earlier 
than elsewhere, that is, about 1700, the dentists began to form a well- 
defined class, to belong to which it was necessary to pass a special exami- 
nation. This examination, as we learn from Fauchard, was held before 
a commission of which no dentist formed a part, and exactly for this 
reason gave but negative results and responded but little to its intended 
aim. The greater number of those who were authorized to practise 
dentistry after undergoing this examination showed a professional ability 
below mediocrity. Nevertheless, although few in number, good and able 
dentists were in no way wanting, as clearly appears from the preface 
to Fauchard's work, and better still from the following paragraph,* 

* Vol. ii, p. 366. 


wherein the author speaks of the great perfection reached by dental 
surgery in Paris: 

"The teeth and the other parts of the mouth being subject, as we 
have seen in the course of this work, to so many important diseases, 
requiring the aid of the most able dentists, it is strange that the sovereigns 
of foreign countries, the heads of republics, and also the administrators 
of our own provinces do not provide for the expense of sending young 
surgeons to Paris, to be instructed in a part of surgery so essential, and, 
notwithstanding, so ignored and neglected everywhere excepting in this 
great city, where it has reached its highest perfection, both as regards 
the embellishment of the mouth and the cure of diseases, often of a 
most serious nature. These scholars would, thereafter, form others and 
would render great services to their nation and to their fellow citizens.'^ 

In the first chapter of his work, Fauchard speaks "of the structure, 
position, and connection of the teeth; of their origin and of their growth.'^ 
He distinguishes in each tooth a body, a root, and a neck, making the 
remark, however, that this last is to be considered as forming part of the 
body. According to the author, the name of "crown" can only be applied 
suitably to the body of the molar teeth, but not to that of the incisors or 
of the canines, which has no resemblance with a crown. Although in 
the adult the number of the teeth is normally thirty-two, it may be that 
some persons have, nevertheless, thirty-one, thirty, twenty-nine, or even 
only twenty-eight teeth, and this independently of any eventual loss, but 
for the simple reason that the wisdom teeth are often cut very late in life 
(even after fifty years of age), or do not all come forth, or sometimes are 
never cut at all. The author refers to some cases of a supernumerary 
tooth situated in general between the two superior central incisors and 
similar in form to the lateral incisors. He also observed two individuals 
who had each thirty-four teeth, sixteen in the lower and eighteen in 
the upper jaw, and in these cases the two supernumeraries were situated 
behind the incisors. Fauchard declares the popular opinion expressed 
also by some ancient authors, of the milk teeth having no roots, to be false. 
The roots of these teeth, he says, are gradually worn away before the 
latter are shed, when the permanent teeth are just on the point of coming 
through; however, if it so happens that one or more of the milk teeth be 
extracted some time before the period in which they are usually shed, 
their roots are found to be as long and as strong in proportion to the body 
as those of the permanent teeth. In children one finds, besides the 
twenty deciduous teeth, the germs of the thirty-two permanent ones, 
for which reason it may be said that children have in all thirty-two teeth 
without counting the germs that may sometimes be found at the extrem- 
ities of the roots of the large molars. As, however, the existence of such 
germs is an exceptional fact, the twelve large molars, if extracted, are 


not ordinarily regenerated. This may be possible, however, if the germs 
in question exist, and, indeed, the author observed two persons in both of 
whom a large molar had been regenerated in the place of the one which 
had to be extracted. 

Fauchard gives an excellent description of the alveoli and of the roots 
of the teeth; he alludes to the varieties which these latter may present, 
and to the importance of the same from the point of view of extraction. 
Thus, speaking of the molars, he says: "Their roots sometimes touch 
one another at the points, whilst at the base, close to the body of the tooth, 
they are far apart. These are the so-called dents barres (barred teeth), 
which it is so difficult to extract, it being unavoidable to bring away 
together with the tooth the spongy osseous part occupying the interval 
between the roots." 

In this same chapter the author calls our attention to some anomalies 
worthy of note. He says that he has observed teeth that seemed to him 
to be derived from the union of two or three germs. He also relates that 
a colleague of his showed him a tooth that appeared to be formed by the 
union of two, between the roots of which was a third tooth whose crown 
was united to the vault formed by the roots of the first two. 

Fauchard describes exactly the pulp cavity and the root canals, and 
speaks of their gradual restriction, ending in an almost entire disappear- 
ance in old age.* He treats of the nerves, of the arteries, and of the veins 
of the teeth in a most detailed manner; then, after alluding to their general 
structure, he goes on to speak of the microscopic constitution of the 
enamel, following in this the description given of it in 1699 by the acade- 
mician La Hire. 

In regard to the development of the teeth, Fauchard repeats what 
Urbain Hemard had previously written. He apparently ignores the 
researches of the Italian anatomists, from whom, and especially from 
Eustachius, Urbain Hemard had literally reproduced all that concerns 

In the second chapter Fauchard speaks **of the maladies of children at 
the period of teething and of the remedies best adapted thereto." Among 
other means of treatment, he advises the incision of the gum when this 
is red, swollen, and distended and the tooth below it can be felt. For 
the incisors and canines a simple incision ought to be made in the same 
curve as the dental arch; for the molars a crosswise incision should be 
made directly down to the tooth below, taking care not to leave any strips 
of uncut gingival tissue, lest these, being distended by the emerging tooth, 
should continue to be the cause of pain and other morbid phenomena. 

Although Fauchard does not tell us anything substantially new about 

* Page 21. 


teething maladies and their treatment, he nevertheless treats this subject 
with much practical good sense, and does not merely make servile repeti- 
tion of what preceding authors have written about it. 

In the three following chapters the author speaks of the utility of the 
teeth, of the rules to be observed for their preservation, of the modes of 
keeping them white, and of strengthening the gums. 

From a passage in the fifth chapter we learn that tooth brushes were 
then already in use. Fauchard, however, advises the use of small sponges 
in their stead. He says: " Those who use brushes of horsehair, or pieces 
of cloth or of linen for cleaning the teeth, do not reflect that all these 
materials are too rough, and that the practice of using them frequently 
and without discretion often exercises a destructive action upon the 
teeth.* Not without good reason, I advise the abandonment of this usage, 
it being preferable, after having had the teeth cleaned by the dentist, 
to wash the mouth every morning with tepid water, and to rub the teeth 
up and down, inside and outside, with a small, very fine sponge wetted in 
water; and it is still better to add to this water a fourth part of aqua vitae 
the better to fortify the gums and render the teeth firm." 

Instead of a small sponge, says Fauchard, the end of a root of marsh- 
mallow or lucern, which has first been subjected to a special preparation, 
may be used with benefit for rubbing the teeth. The author gives a 
long and minute description of this preparation, which we, however, 
omit, because devoid of historical interest. 

As, however, the above means are not always sufficient for preserving 
the teeth and gums in good condition, it is necessary in many cases, says 
Fauchard, to make use of some paste, powder, or mouth wash. The 
author mentions a great number of compositions of this kind, giving the 
formula for each one — almost always most complicated — and indicating 
the peculiar advantages of each of them. We will here quote one of the 
formulae as an example. 

^^ A spirituous watery desiccativey balsamicy anttscorbuticy efficacious 
against many maladies of the mouth: 

"I^ — good sarsaparilla, four ounces; aristolochia rotunda, dried rinds 
of bitter organes, of lemons, and pomegranates, ana three ounces; pyre- 
thrum, two ounces; cloves, one ounce; mustard seeds, one ounce; wild 
rocket seeds, two ounces. Pound well in a mortar and put the whole into 
a retort with a long neck. Add thereto half a pound of pulverized 
candied sugar and the same quantity of clarified rose honey. Pour in 
three pints of good spirit of wine. Cork the retort well and leave all to 
digest in a cool place for five or six days. Then heat the retort forty-eight 
hours in the water bath over a slow fire, without letting the liquid come 

» Pages 73, 74. 


to the boil. Afterward, when cold, decant in a glass bottle, to be kept well 
corked. Pour another three pints of spirit of wine on the residue of the 
drugs; cork the retort again, replacing it in the water bath for forty-eight 
hours, and regulating the fire as above. Then, after letting it cool, 
pour off the liquid into the same bottle. Next remove all the residue from 
the retort, place it in a thick, white linen cloth, and force the remaining 
liquid through it, and add to that in the bottle. Put back half of the 
entire quantity of liquid in the same retort, and add thereto aloetic 
elixir and haume du command eury ana four ounces; pulverized dragon's 
blood, three ounces and a half; pulverized gum of guaiac and Peruvian 
balsam, ana three ounces; gum lac, two ounces. Cork the retort again 
and replace it in the water bath for forty-eight hours, as above. Let 
cool, decant the liquid in another glass bottle, and cork well. Pour the 
remaining half of the first liquid upon the rest of the drugs, replace 
the retort in the water bath for forty-eight hours, let cool, and pour the 
contents in the last bottle. Filter the liquid well, and pour it into a bottle 
of sufficient size to be able to add the following liquids: aqua vulneraria 
and first cinnamon water, ana three pints; second cinnamon water, three 
half-pints; spirit of cochlearia, four pints. Shake the bottle well, filter 
again, and store in well-corked bottles." 

The author adds that the doses of the different drugs may be reduced 
in proportion to the quantity of liquor to be prepared; and that he pre- 
pares so large a quantity at a time because of the great sale he has for it 
among his clients. 

The preparation in question is counselled by the author as a remedy 
against pathological conditions, and of the gums especially. One makes 
use of it in the following manner: Pour from seven to eight drops into a 
wineglass of water; wet the tip of the finger and rub the gums and the 
teeth wiell. Or mix seven or eight drops in a good spoonful of water, 
using a fine sponge to rub the teeth and gums. 

The example we have cited suffices to show how much care one took 
at that time in the preparation of substances destined to be used in the 
preservation of the teeth, and demonstrates at the same time that Fauch- 
ard, inventor of that and many other preparations, besides being an able 
surgeon dentist, was also exceedingly well versed in dental materia medica. 

Chapter VII treats of the general causes of dental, alveolar, and gingival 
diseases, and contains the complete enumeration of these maladies. 
The causes of dental affections may be of two orders, viz., internal (general 
diseases, dyscrasic conditions) and external (the action of heat and cold, 
mechanical causes, etc.). 

After having spoken in particular of various causes, Fauchard adds: 
"Little or no care as to the cleanliness of the teeth is ordinarily the 
cause of all the maladies that destroy them." 


The author divides maladies of the dental apparatus into three classes, 
that is: 

1 . Maladies deriving from external causes and acting, therefore, espe- 
cially on the crown or uncovered part of the tooth. 

2. Maladies of the hidden parts of the tooth, that is, of the neck and 

3. Symptomatic maladies, deriving from the teeth. 

In the first class the author includes 45 pathological states, 17 in the 
second and 41 in the third, making up a total of 103 morbid conditions. 
This should be sufficient to give us an idea of the accuracy with which 
Fauchard studied the maladies of the dental apparatus, especially if one 
considers that preceding authors had reduced these maladies to a very 
small number. Fauchard's classification is very complete, for not- 
withstanding the progress made in succeeding years in this science, the 
pathological conditions not to be found comprised in it are exceedingly 
few. Naturally, the 103 diseases enumerated by Fauchard do not repre- 
sent as many distinct morbid entities. The author, in classifying dental 
maladies, keeps especially in view the requirements of the practitioner, 
and therefore makes numerous distinctions in each morbid process. 
Thus, he distinguishes a great many varieties of caries, viz., the soft and 
putrid caries, the dry caries, the caries in part dry and in part soft, the 
caries complicated by fracture, the superficial caries, the deeper and the 
deepest, the caries of the different surfaces of the crown, and so on. 
/Also in the classification of other morbid processes, Fauchard makes 
multifarious distinctions. 

The passage referring to worms in the teeth deserves to be here 

"Sometimes worms are to be found in the carious cavities of the teeth, 
or in the deposit of tartar that covers them, and to these the name of dental 
worms has been given. Observations recorded by illustrious authors 
are extant which attest this. Not having ever seen these worms, I neithet 
admit nor deny their existence. Nevertheless, I conceive the thing nor 
to be physically impossible, although at the same time I do not believe 
at all that these worms destroy the teeth or cause them to decay, but rather 
that the eggs of some insect having been introduced into the carious cavity 
of the tooth, either through alimentary substances or through the saliva, 
these eggs thus deposited have developed and produced the worms 
alluded to. However this may be, as they are not the real cause of the 
caries, their eventual presence does not require any particular considera- 
tion." Fauchard again recurs to the subject of worms in Chapter VIII, 
in speaking of the particular causes of caries.^ 

* Vol. i, p. 131. • Page 142. 


" It was, and is still, believed by the vulgar and also by some writers 
that all toothache is caused by worms, which little by little destroy the 
tissue of the osseous fibers and the nervous threads. If this were so, the 
explanation of pains and of decay in the teeth would be very simple. This 
opinion is founded on pretended experiences relating to these insects, 
which may, it is said, be made to fall out of the teeth by the smoke of 
henbane seeds; this, however, has been declared fabulous by Andry, 
dean of the medical faculty of Paris, as well as other similar facts which 
he exposes in his book on the generation of worms. ^ 

** Andry relates, however, that with the help of the microscope one may 
succeed in seeing certain worms that form beneath the deposit collected 
upon the teeth as the effect of want of cleanliness; these worms, he says, 
are exceedingly small and characterized by a small round head with a 
small black spot; the body is long and fine, pretty nearly like the worms 
seen in vinegar through the microscope. He adds that these worms 
destroy the teeth little by little, causing a bad odor, but not much pain. 
He believes it an error of the imagination to ascribe violent pains in the 
teeth to dental worms, and holds that these only produce a very slight, 
dull pain accompanied by itching. 

"I have done everything possible," continues Fauchard, "to convince 
myself with my own eyes of the existence of these worms. I have made 
use of the excellent microscopes of Manteville, sworn surgeon of Paris, 
and have made a great number of experiments with them both on caries 
in teeth newly extracted as well as on tartar of different consistency 
accumulated on the same, but have never succeeded in discovering 
any worms. I am also still less disposed to believe in the existence of 
these animals, because Hemard declares that he has never been able to 
find any worms in carious cavities. I am thoroughly convinced of Andry 's 
sincerity; neither do I doubt the truth of the facts he relates; but it is 
easy to perceive from his own words how little the pretended healers of 
teeth and their specifics for killing worms are to be held in account; from 
the moment that, according to this writer, the pains for which one is 
most obliged to have recourse to remedies are almost always those not 
proceeding from the cause in question." 

In short, Fauchard does not believe at all that dental caries is 'occa- 
sioned by worms; and only from respect for the authority of Andry and 
other writers does he admit the accidental existence of these little animals 
in the carious cavities or upon the teeth, refusing, however, to attribute 
any importance to the same as regards the etiology of caries. 

This disease, says Fauchard,^ is produced by a humor that insinuates 
itself into the midst of the osseous fibers of the teeth, and displacing the 

* De la generation des vers dans le corps de rhomme, Paris, I'joo. * Vol. i, p. 143. 


particles which compose these fibers, gives rise to their destruction. The 
causes from which these disorders derive may be external or internal. 
The external causes are blows, violent efforts made by the teeth; the 
improper use of the file, the application of acids or of other substances 
that injure the enamel, alteration of the saliva, impressions of heat or 
cold, and also certain kinds of nourishment. Blows or violent efforts 
may produce caries, according to the writer, by occasioning the effusion 
of the liquid contained in the vessels. The author gives analogous 
explanations for the other external causes. As to the internal causes, 
they consist, he says, in alteration of the blood and of the humors. 

The teeth, says Fauchard, are more subject to caries than all the 
rest of the bones in the human body, because, their tissues being denser, 
the vessels are on this account closer together and more easily liable to 
be obstructed, choked up, and broken. Besides, the position of the teeth 
exposes them more than the other bones to the immediate action of external 
causes capable of producing the disorders alluded to; and finally, what 
demonstrates the dental caries to be produced, for the most part, by 
external causes, is that false teeth, either human or formed from those 
of animals, sometimes become carious just in the same way as the natural 
ones; which evidently happens by the sole action of external causes. 

It is undeniable that the ideas expressed by Fauchard on the patho- 
geny of caries, cannot hold good against criticism. Nevertheless, we 
owe a great deal to this author for having once for all put an end to the 
ridiculous theory of dental worms, and for having tried to find a reason- 
able explanation of the manner in which caries is produced. 

The teeth, says Fauchard, have not all the same disposition toward this 
morbid process; indeed, notable differences are to be observed in this 
respect. The molars are, in fact, more apt to become decayed than the 
incisors or the canines; and the upper incisors and canines are more 
subject to this disease than the inferior ones, because, by reason of their 
position, they are more frequently uncovered and more exposed to heat 
and cold, whether in eating and drinking or whether in the mere aspira- 
tion or expiration of the air. It is to be observed, besides, that when 
the eruption of the last molars is considerably delayed they easily decay.* 

Having very frequently observed the symmetrical decay of correspond- 
ing teeth on both sides of the same jaw, Fauchard considers that these 
cases are not simply accidental, but rather holds that the fact depends 
on a special cause, which, however, is not easy to determine. He offers, 
at any rate, a sufficiently good explanation when he says that as certain 
morbid causes (bad humors, etc.) must affect both sides of the mouth 
identically, it is but natural that the effects of such causes should be 

* Page 149. 


altogether analogous on the right and on the left, and manifest themselves 
symmetrically on teeth having the same configuration, the same structure, 
and the same consistence. 

Before speaking of the treatment of caries,* Fauchard alludes to the 
fallaciousness of the many remedies against toothache which were largely 
sold at his time by charlatans and impostors of every kind. 

"Some pretend to cure toothache with an elixir or some special essence; 
others with plasters; others by means of prayers and signing with the cross; 
others with specifics for killing the worms that are supposed to gnaw the 
tooth and so cause pain; others pretend to be so clever that they can cure 
the most inveterate toothache by merely touching the tooth with a finger 
dipped into or washed with some rare and mysterious liquid; others 
finally promise to cure every kind of toothache by scarifying the ears with 
the lancet or cauterizing them with a red-hot iron." 

"I am well aware," adds Fauchard, "that it can be alleged in favor of 
this last prejudice that the celebrated Italian doctor Valsalva indicates 
with great precision the point in which the actual cautery is to be applied 
to the ear, in order to calm toothache. He also determines the size of 
the iron and the manner of applying it. The authority of so celebrated 
an author, whose opinion is certainly worthy of respect, should induce me 
to believe that there may perhaps be some cases in which it is possible 
to use this remedy with success; nevertheless, I cannot persuade myself 
that such treatment can be useful in common cases of toothache. 

"At Nantes, a city of Brittany, I knew a Turk, a watchmaker by 
profession, who was renowned for this mode of curing toothache. But 
I also know that, in spite of the pretended cures, the greater number of 
those who put themselves into his hands were obliged finally to have 
recourse to me, in order to find relief for their suflFerings. I afterward 
saw several other persons use the same remedy with no better success. 

"There are, besides, an infinity of other remedies vaunted as efficacious 
against toothache, but the greater number of them are so ridiculous and 
extravagant that it would be both tiresome and useless to speak of them. 
We will, nevertheless, give one more mentioned by M. de Brantome."' 

The author here quotes a passage of this writer, wherein he says that, 
having been suffering from toothache for two days, the apothecary 
of Klizabeth of France, wife of Philip II of Spain, brought him a most 
singular herb, which when held in the hollow of the hand had the virtue 
of making the pain cease immediately; and in this way he was, in fact, 
effectually cured. 

And here Fauchard expresses himself of the same opinion as Urbain 
Hemard, who believes the cure of toothache by means of words, or by the 

* Chap, ix, p. 154. ' Dames illustres, vie d'Elizabeth, p. 179. 


touch of paper on which certain signs are written, or remedies held in the 
hand, etc., to be merely the effect of the force of the imagination, and he 
opines that the patient, having a vivid belief in the mysterious thing 
proposed to him remains under the impression of an inward commotion,, 
by the effect of which it may well be that the morbid humor is deviated 
from the painful part to other parts of the body. The effects of the various 
passions on the bodily functions are, says Fauchard, very well known. 
Thus, when under the influence of anger the wounded at times do not 
feel any pain, and those who suffering from a tormenting toothache go 
to a dentist to have the tooth drawn are sometimes seized by such great 
fear as not to feel the pain any longer, and go away, only to return later 
on renewal of their sufferings; although there have been cases where the 
pain ceased altogether. 

In spite of this explanation, of which we will not here discuss the value, 
allowing it, however, as satisfactory enough, Fauchard continues by making 
a most curious consideration, which as it is of a somewhat surprising 
effect in a scientific work, we will not deprive our readers of it. He believes 
it to be his duty to give the following warning, namely, that "the modes 
of cure, by means of certain words, of certain signs, laying on of hands> 
written charms, etc., savoring much of superstition and of diabolic 
artifice, are prohibited by the Church as sinning against the first Com- 
mandment, as much in him who practises them as him who consents 

After the above preliminaries, the author passes on to treat the impor- 
tant subject of the mode of curing caries.^ According to him, when 
caries has not yet attacked the internal cavity of the tooth at all, or only 
in a very slight degree, there are four modes of curing it: the first consists 
in the use of files or scrapers, the second in the application of lead, the 
third in the use of oil of cinnamon or of cloves, and the fourth in the 
application of the actual cautery. Fauchard expresses most energetically 
his disapproval of the means of cure recommended by Dionis in cases 
of caries of the triturating surfaces, which consisted in the cauterizing 
of the decayed spot with a drop of oil of vitriol applied by means of a 
miniature paint brush, declaring this to be both dangerous and hurtful 
because of the destructive and corrosive action of the oil of vitriol and 
because of the impossibility of limiting its action solely to the affected part 
of the tooth. 

The general method of cure followed by Fauchard is described by him 
in these terms: 

**When a tooth is but slightly decayed, it is sufficient to remove the 
caries with the instruments of which I will speak hereafter, and to fill 

* Pa^e i6i. 


the cavity with lead. If, however, the cavity be rather deeper and occa- 
sions pain, one should, after having scraped it, put a small ball of cotton- 
wool soaked in oil of cinnamon or of cloves into the hollow of the caries 
every day. This medication must be continued for a sufficient time, 
taking care to squeeze in the cotton-wool by degrees to accustom the 
sensitive parts to the pressure. Four or five days later one removes 
the material from the carious cavity. This treatment sometimes prevents 
a return of the pain; it produces on the osseous fibers of the tooth a 
slight but sufficient exfoliation and impedes the progress of the caries. 
If the pain should not cease after having continued this method for a 
sufficient length of time, one should then have recourse to the actual 
cautery and stop the tooth after a certain time, if the form and situation 
of the decayed cavity permit it; for one sometimes meets with cavities 
that are not able to maintain the stopping. 

" If the caries penetrates as far as the cavity of the tooth, it may give 
rise to an abscess; and this I have often observed in persons to whom the 
caries of the incisors or of the canines occasioned great pain. In such 
cases I introduce the extremity of the sound into the cavity of the tooth 
in order to facilitate the evacuation of matter. As soon as the pus is 
evacuated the pain ceases. I then leave these patients in repose for two 
or three months; after this time, I stop the decayed tooth or teeth to avoid 
their getting worse." 

As anyone may perceive, the methods used by Fauchard against caries 
left much to be desired, when compared with those now in use. With 
such imperfect methods it is but natural that one did not always succeed 
in obtaining the immediate cessation of the pain resulting from caries. 
The want of additional remedies was, therefore, felt; and, in fact, Fauchard 
tells us* of two with which he had experimented and found most efficacious 
against toothache. The first is a resinous plaster to be applied to the 
temples; the other is a paste to be applied, in quantity equal to the size 
of a small bean, between the gums and the cheek, and which was com- 
posed of various ingredients, among others, pyrethrum, black pepper, 
ginger, stavesacre, mace, cloves, cinnamon, sea salt, and vinegar. After 
having given the mode of preparation and application of the two above- 
mentioned remedies, Fauchard adds: "These remedies prove especially 
efficacious if one takes care to introduce a little cotton-wool or lint into 
the decayed cavity, soaked in oil of cloves, or cinnamon, mixed with 
an equal quantity of extract of opium, and if one resorts opportunely to 
bleeding and purging; which ought never to be neglected in the case of 
plethoric persons.*' 

Finally, the author speaks of another remedy,' and one which we 

* Page 165. • Page 167. 



never should have expected to find in his book; but he assures us that 
by it many persons who had almost all the teeth decayed and suffered very 
often from toothache found great relief. 

** It consists in rinsing the mouth every morning and also in the evening 
before going to bed with a few spoonfuls of one's own urine immediately 
after it has been emitted, always provided the individual be not ill. One 
is to hold it in the mouth for some time, and the practice ought to be 
continued. This remedy is good but undoubtedly not pleasant, except in 
so far as that it procures great relief. Some of those to whom I have 
recommended it, and who have used it, have assured me that in this 
manner they were relieved of pain to which, up to then, they had con- 
tinually been subject. It is rather difficult in the beginning to accustom 
one's self to it; but what would one not do to secure one's self health 
and repose." 

In order to explain the virtue of the urine as a remedy, the author 
pauses to speak of its chemical composition, and then adds: 

**The rectified spirit of urine* could be substituted for the human urine. 
One should then take two drams of this substance and mix it with two 
or three ounces of aqua vitae, or water of cresses or of cochlearia. Sal 
volatile^ has the same virtues. Those who wish to make use of it should 
dissolve fifteen to thirty grains of it in the same quantity of the above 

Fauchard then passes on to speak of trepanning of the teeth when 
they are worn away or decayed and cause pain.' He begins by saying 
that most varieties of pain caused by the canines and the incisors when 
worn away or decayed cease after the use of the trepan. He, however, 
understands the term trepanning in a very wide sense, comprehending 
therein the use of any instrument whatever (even a needle or a pin) with 
which one penetrates into the inner cavity of the teeth. 

In interstitial caries of the canines and incisors one ought, says Fauch- 
ard, first to enlarge the interstice with a small file of a convenient shape, 
then to scrape the decayed cavity, and finally to open up the canal or inner 
cavity of the tooth with a perforator or with a small trepan. 

*' In this way the pus or other humors that may have collected in the 
tooth can easily find their way out, and the pain will cease at once or in 
a short time." 

The author describes with much minuteness the manner of trepanning, 
and then adds: 

** After this operation one should let a few weeks pass without doing 
anything to the affected tooth, and afterward, in order to impede further 
decay, one must put a little cotton-wool into it soaked in oil of cinnamon 

* Liquid ammonia. ^ Subcarbonate of ammonia. ^ Chap, x, p. 169. 


or of cloves. The tooth must be left in this state for some months, taking 
care to renew the cotton-wool. It is necessary to observe that in beginning 
to put in the cotton-wool this should be done with lightness and without 
pressing it down much, so that if pus should gather again it may be able 
to make its way through the cotton-wool, the principal object of this 
being to hinder the penetrating of alimentary substances into the tooth, 
which would be the cause of further decay. If the cotton were pressed 
into the tooth from the beginning, the pus, not being able to find an exit, 
would accumulate, and might cause much pain, if the nervous parts 
of the tooth were not yet dried up or destroyed. The same thing 
might happen after the application of a lead stopping, and one would be 
obliged to remove it and let considerable time pass before putting it in 

Further on the author says that while the trepanning of incisors or 
canines almost always causes the pain to cease, by opening up an exit 
to the morbid matter retained within the cavity of such teeth, the same 
is not the case with the molars, these having several roots and several 
cavities, of great variety, which lend themselves but little to accurate 
trepanning. "Hemard," he adds, "judges it necessary to extract these 
teeth, or at least to break off the crown {les dechapeller)^ in order to give 
exit to the corrupt matter that is closed up in the cavity; this sometimes 
causes the pain to cease. He (Hemard) says that he has seen many 
abscesses in the interior of teeth, which were not externally decayed, and 
that after having broken oflF the crown he found within the cavity a 
corrupt matter of an insupportable smell.*' 

Relative to such cases, Fauchard says that, besides the teeth, also the 
surrounding parts suffer and are imperilled by these conditions. **The 
greater part of the violent fluxions deriving therefrom often terminate in 
abscesses and fistulae of the gums and of the surrounding parts, and 
sometimes with considerable and dangerous decay of the bone, as I have 
related in some of my observations." 

One sees that Fauchard was clinically very well acquainted with the 
grave forms of pulpitis and their possible consequences, although ignoring 
the true nature of this process, which has only been studied and illustrated 
much more recently. 

Chapter XL (page 177) treats of dental tartar, of its cause, of the harm- 
ful effects it produces, and of the prophylaxis and therapy relating thereto. 
Three illustrations which are added to this chapter represent the dif- 
ferent aspects of a mass of tartar of exceptional size formed around the 
body of a lower molar. The surgeon Bassuel, a friend of the author, 
had removed this mass of tartar, together with the entire molar, from the 
jaw of an old woman. The mass itself was almost the size of a hen's 
egg, the superficies being very irregular; it rendered mastication altogether 


impossible and caused the cheek to stand out in such a way as to give 
the appearance of a tumor. ^ 

In the following chapter^ the author enumerates the various dental 
operations: ** Cleaning the teeth, separating them, shortening them, 
removing the caries, cauterizing, stopping, straightening crooked teeth, 
steadying loose teeth, trepanning, simple drawing of teeth, replacing them 
in their own alveoli, or transplanting them to another mouth, and finally 
substituting artificial teeth for those wanting.'* He then adds: "All 
these operations require in him who carries them out a light, secure, and 
skilful hand and a perfect theoretic knowledge, by which he may decide 
on the opportuneness of performing them, of deferring them, or of 
abandoning them altogether. In fact, one may know perfectly well 
how to carry out an operation and nevertheless undertake it in a case in 
which it is not at all proper to operate. Into such an error no one can 
fall save through sheer ignorance of the cause of the disease or of the right 
means of curing it. From this it must be concluded that the knowledge 
required in order to be a good dentist is not so limited as some imagine, 
and that the imprudence and the danger of placing one's self in ignorant 
hands is as great as the temerity of those who undertake to exercise so 
delicate a profession without the knowledge of even its first elements." 

Before speaking in detail of all the above operations, the author dedi- 
cates a lengthy chapter'' to describing with the greatest minuteness the 
position to be given in general, as well as in special cases, to the head and 
body of the patient, and the manner in which the dentist should place 
himself with regard to the former, so as to be able to make a proper use of 
each of his hands. As a rule, Fauchard made the patient seat himself 
in a convenient arm-chair; in exceptional cases he placed him on a sofa, 
or on a bed. He draws this subject to a close with the following words: 

" It is, indeed, surprising that the greater part of those who practise 
tooth drawing should ordinarily seat the patient on the ground, this 
being both indecent and not very clean. This position is not only un- 
comfortable, but causes sometimes a sense of fear, especially in pregnant 
women, to whom it may, besides, prove very harmful. But it is still 
more surprising that certain authors should even nowadays affirm this 
to be the most convenient position, while it is instead one to be entirely 

In speaking of extraction of the teeth, ^ Fauchard begins by saying that 
the milk teeth, although destined to be shed, should never be extracted, 
except in cases of absolute necessity, as, for instance, when being decayed, 
they give rise to intolerable pain. The alveoli of the infantile jaw are 

* Page 407. * Chap, xii, p. 183. 

'Chap, xiii, p. 185. * Chap, xiv, p. 194. 


weak, whilst the roots of the deciduous teeth are sometimes firmer and 
more solid than one would believe, and hence it is that in extracting a 
milk tooth one runs the risk of injuring the alveolus and even of carrying 
away a portion of it altogether with the tooth, not to speak of the danger 
of damaging or even destroying the germ of the permanent tooth lying 
below. Besides, Fauchard adds, there are sometimes deciduous teeth 
that are never shed and never renewed. One must, therefore, defer 
drawing children's teeth as long as possible unless they are loose. When, 
however, intolerance of pain or a caries endangering the integrity of 
the neighboring teeth oblige one to recur without delay to extraction, one 
should carry out the operation with prudence and judgment, so as to 
avoid the dangers alluded to. It sometimes happens, says Fauchard, 
that one finds in children a crooked tooth by the side of a straight one; 
\n these cases ignorant tooth drawers have often been known to remove 
the crooked (permanent) tooth, and to leave the straight, viz., the decidu- 
ous one, which afterward falls of itself, the individual thus remaining 
deprived of one of his teeth for the rest of his life. The rule to be observed 
in order to avoid a similar error is always to extract the older of the two 
teeth and to leave the one that has been cut more recently, which is easily 
recognized by its being ordinarily firmer in the socket and of a better color 
than the first. 

And here the author inveighs against all the charlatans of his day who 
dared, without being dentists, to perform dental operations, and whose 
number, it would seem, was ever increasing, so much so that he is led 
to exclaim: "There will shortly be more dentists than persons aflpected 
with dental diseases!" In proof of this he relates the case of a cutler of 
Paris, who extracted the molar tooth of a young girl because black spots 
having appeared on it, he believed it to be decayed; but perceiving 
that he had only removed the crown (it was a deciduous tooth about to 
fall out), and thinking that he had broken the tooth, proceeded to extract 
the root, removing, in his gross ignorance, the permanent tooth on the 
point of coming through. 

Returning to the indications for the extraction of teeth, Fauchard says 
that when a tooth planted irregularly in the mouth cannot be straightened 
by any of those means to which he afterward alludes, and occasions 
damage or inconvenience or constitutes a deformity, the sole remedy is 
its removal. As to decayed teeth and the pain that they produce, when 
the evil cannot be remedied with oil of cinnamon or oil of cloves, with the 
actual cautery, or by stopping, one must have recourse to extraction, and 
this to satisfy four different indications, that is, before all, to procure the 
cessation of violent pain; in the second place, to prevent the caries from 
being communicated to the neighboring teeth; thirdly, to remove the 
fetid smell deriving from the substances that are retained within the 


carious cavity, and to impede the teeth on th© same side from becoming 
covered with tartar, as inevitably happens when by reason of painfulness 
in eating they are forced to be inactive; fourth and lastly, because the 
dental caries, not infrequently gives rise to other diseases, which ordinarily 
cannot be cured unless the cause from which it arises be recognized 
and suppressed. 

"Sometimes,** continues Fauchard, "such violent and obstinate pain 
arises in a tooth that we are obliged to extract it, although not decayed 
nor presenting deformity." 

The author combats the old prejudice, that it is not right to draw 
teeth in cases of pregnant women or of nursing mothers, lest the operation 
should prove dangerous to the patient or to the fetus, or produce alteration 
or arrest of the milk secretion. Only the fear arising from this preju- 
dice can, according to the author, cause any of the dreaded contingencies. 
The dentist ought, therefore, to seek to dissipate the fears of these patients, 
by persuading them of the innocuous nature of the operation as well as 
of its short duration, and should represent to them, on the other hand 
(if the operation be really necessary), the advantages of promptly deciding 
on it, to avoid the harm and the peril that prolonged suffering and the 
tortures of sleeplessness might occasion to themselves as well as to the 
unborn child or to the suckling infant, such as abortion, premature 
confinement, alteration of the milk, etc. 

According to Fauchard, "one should always take the precaution of 
hiding the instruments from the patient's sight, especially in the case of 
extracting a tooth, so as not to terrify him." 

The author then speaks of cases where it is necessary to open the jaws 
by force;^ of the instruments to be used; of the mode of employing them; 
of all the precautions to be observed under such circumstances; of the 
necessity that may eventually arise of sacrificing some one tooth when 
the enforced opening of the jaws has been impracticable; of the advisa- 
bility of sacrificing preferably in such cases one of the premolars in 
order to damage as little as possible the masticatory function and the 
appearance of the face; of the instruments best adapted for carrying out 
this operation; of the danger it presents and of the best mode of avoid- 
ing it; finally, of what it is necessary to do in given cases to keep the 
mouth open, in order to not be obliged to repeat the operation a second 

The six following chapters of the first volume treat very extensively of 
the anatomy and physiology of the gums,^ of gingival diseases and their 
treatment.' Th6 subject is treated in a masterly manner, although these 
chapters do not offer anything of original importance. 

* Chap. XV, p. 205. * Chap. xvi. ' Chap, xvii to xxi. 


The same may be said of Chapter XXII, in which the author speaks 
of scorbutic affections and of their treatment. 

The chapters we have cited are accompanied by four plates, repre- 
senting thirteen instruments for use in the treatment of the above diseases. 

Instruments for opening the mouth in cases of lockjaw (Fauchard). 

The author then speaks' of the accidents which may arise from caries 
and from other dental diseases, not only in the parts nearest to the teeth, 
but also in localities more or less distant from them, for example, fistula; 

' Chap, xjtiii, p. zSa. 


reaching as far as the cheek bone or the eye, necrotic destruction of the 
maxillary bones, etc. 

The first volume of Fauchard's work finishes with a collection of most 
interesting cases, which may be read even at the present day with pleasure, 
and from which one may derive some useful information. These cases 
are about eighty in number, spread over fifteen chapters, according to 
the various nature of the cases themselves. This valuable collection 
gives clear evidence of Fauchard's eminence both as operator and observer, 
and aflFords at the same time an idea of the extent of his practice which 
enabled him to collect so considerable a number of cases of more than 
common interest. 

Chapter XXV contains some observations on ^^well-authenticated cases^* 
of regeneration of permanent teeth in individuals of ages varying from 
fifteen to seventy-five years. We will here give two of them by way of 
curiosities : 

** In the year 1708 Mademoiselle Deshayes, now the wife of M. de Seve, 
residing at Paris in rue de Baune, and who was then fourteen years of 
age, had the first large molar on the right side of the inferior jaw extracted 
by me, because decayed and causing pain. The following year she re- 
turned to have her teeth cleaned by me, and whilst doing this I observed 
that the tooth extracted had been wholly regenerated."^ 

"In the year 1720 the eldest son of M. Duchemin, player in ordinary to 
the King, who was then sixteen years old, came to me to have the second 
large molar on the left side of the lower jaw extracted. It was very 
much decayed. I drew it, and a year and a half after the tooth was 
completely regenerated.*'^ 

In Chapter XXVIII the author relates twelve cases of dental irregular- 
ities corrected by him with satisfactory and at times even surprising 
results. We here refer, in Fauchard's own words, to the last two of these 
cases, not because of their being the most important, but because 
from them it is evident that Fauchard was not the only dentist who 
undertook such corrections, although he was perhaps the only one who, 
in certain cases, carried them out with a rapid method. 

"In the year 1719 M. Tabbe Morin, about twenty-two years of age, 
whose countenance was greatly deformed from the bad arrangement of 
the incisors and canines, consulted various colleagues of mine as to the 
possibility of correcting the irregularity of his teeth. Some found the 
thing so difficult that they advised him to do nothing at all, that is, not to 
risk any attempt. He came to me by chance one day whilst another dentist 
was with me. We both examined his mouth with much attention. 
Now, as this dentist was my elder, and I believed him to have more experi- 

' Page 330. ^ Page 331. 


ence than I had, I begged him to give me his opinion as to the best method 
to follow in this case, in order to insure success. Whether it be that he 
would not give me advice, or that he was not in a position to be able to do 
so, the fact is, that his answer was not such as I could have wished. I 
therefore felt myself obliged to tell him that I hoped to put this gentle- 
man's teeth in order within three or four days. My colleague was not 
aware that this could be done so quickly; urged by curiosity, he returned 
when the time I had indicated had elapsed, and found, not without sur- 
prise, M. Morin's teeth reduced to perfect order."* 

"Several years ago the wife of M. Gosset, Reviseur des Comptes, sent 
for me to examine the teeth of her daughter, then twelve years of age. 
I found the lateral incisor on the left side of the lower jaw strongly inclined 
toward the palate in such a manner as to constitute a real disfigurement. 
Interrogated by the mother as to the possibility of remedying this, I 
replied that it could easily be done in eight or ten days, with the method 
of threads, if the young girl were only sent every day to my house. As, 
however, the young lady received instruction from several masters who 
came to her house each day, my proposal was not accepted, in order not 
to distract her from her studies. This induced me to say to the mother 
that, if she were willing, I would put the crooked tooth into its natural 
position in a few minutes. Surprised at so short a time being demanded 
for the operation, she consented to my performing it immediately. Making 
use of the file, I began by separating the tooth from the neighboring ones 
which pressed upon it, slightly diminishing the space it ought to have 
occupied. This done, I straightened the tooth with the pelican, placing 
it in its natural position, to the great astonishment of the young girl's 
mother and of other persons present, who told me they had many times 
seen similar corrections that had been carried out by the late M. Car- 
meline and others, never, however, with this method or in so short a 
time. As soon as I had reduced the tooth to its normal position I fixed 
it to those next to it by means of a piece of common thread, which I left 
there eight days; and during that time I made the young girl rinse her 
mouth four or five times a day with an astringent mouth wash. After 
the tooth had become firm, it would not have been suspected that it had 
ever been out of its normal position.'*^ 

In Chapter XXX the author gives an account of five cases of dental 
replantation and one of transplantation. This last operation was carried 
out on a captain who had the upper canines on the left side decayed and 
aching; he inquired of the author if it were possible to draw it and replace 
it by another person's tooth. Having received an affirmative reply, the 
officer sent immediately for a soldier of his company to whom he had 

> Page 368. - I'age 370. 


already spoken on the subject. This man's canine was found by 
Fauchard to be too large; nevertheless, for want of better he extracted and 
transplanted it, after having diminished it in length and in thickness. 
This it was not possible to do without the cavity of the tooth remaining 
open, and for this reason, when, after about two weeks* time it had become 
quite firm, he stopped it. But the stopping immediately caused such 
insupportable pain (which circumstance astonished the writer not a 
little) that he was obliged to take it out again the following day, on which 
the pain ceased directly. Fauchard saw this patient eight years afterward, 
and was assured by him that the transplanted tooth had lasted him six 
years, but that its crown had been gradually destroyed by caries. The 
root had been extracted by a dentist, not without considerable pain.* 

We now give one of his cases of replantation in the words of the author 

"On April lo, 1725, the eldest daughter of M. Tribuot, organ builder 
to His Majesty the King, called on me; she was tormented by violent 
toothache caused by caries of the first small molar on the right side of 
the upper jaw; but although she was desirous of having the tooth removed, 
to be freed of the pain, she, on the other hand, could not, without difficulty, 
make up her mind, thinking of the disfigurentent which its loss would 
occasion, and thus it was that she was induced to ask me if it would not 
be possible to put it back again after having extracted it, as I had already 
done in the case of her younger sister. I replied that this might very well 
be done, provided the tooth came out without being broken, without 
any splintering of the alveolus, or great laceration of the gum. The 
patient, upon this, completely made up her mind. I extracted the tooth 
very carefully so as not to break it, neither were the gum nor the alveolus 
injured in any way. I therefore was induced to put the decayed tooth back 
in its alveolus, and having done this, I took care to tie it to the neighboring 
teeth with a common thread, which I left in position for a few days. 
The tooth became perfectly firm, and only caused pain for two days 
after being replanted. . . . To better preserve it, I stopped the carious 

Not without interest is a case of disease of Highmore's antrum, origin- 
ating in the following way. A charlatan attempted to extract by means of 
a common key a canine tooth which had erupted in an abnormal position. 
He applied the hollow of the key to the tooth and beat upon the handle 
with a stone. But the tooth, instead of penetrating into the hollow of 
the key, was driven into the maxillary sinus.^ 

Two important cases of *' stony excrescence" of the gums (probably 
osteomas) are to be found in Chapter XXXII. One of these tumors 

* Page 383. " Page 376. ^ Chap, xxxi, p. 391. 


was removed by the dentist Carmeline after the patient had been tortured 
with useless operations by surgeons, who, not recognizing the true seat of 
the evil and mistaking it for a tumor in the cheek, had, over and above 
all the rest, produced a permanent disfigurement of the patient's face and 
a perforation of the cheek that he was obliged to keep closed for the 
remainder of his life with a wax plug, to prevent the exit of the saliva 
and of liquid or masticated aliments.^ 

Several important observations on obstinate cases of cephalalgia, pro- 
sopalgia, otalgia, and other varieties of pain arising from dental caries 
are to be found in Chapter XXXIII. In all these cases the removal of 
the decayed tooth or teeth procured the prompt cessation of pain. Among 
others worthy of note is a case of violent otalgia caused by the 
decay of a lower molar, which, however, was itself not painful. This 
circumstance drew Fauchard himself into error, causing him to believe 
that the otalgia was independent of the decayed tooth; he therefore 
merely stopped the tooth to prevent the caries from extending farther. 
The pain in the ear continued, however, and the patient therefore con- 
sulted a doctor of the Faculty of Paris, Coutier, who told her that the 
decayed tooth might be the cause of the earache, and that, therefore, 
before undertaking any other cure, she ought to have it extracted. This 
advice was followed and the earache ceased promptly and completely.^ 

In another case a patient twenty-seven years of age was tormented 
by violent pain in all her teeth on the left side, in the temple and the 
ear, as well as in the chin, the palate, and the throat. The doctors and 
surgeons consulted decided the cause to be rheumatism. The patient 
was bled not less than four times and subjected to various other methods 
of treatment (purgatives, clysters, poultices, etc.), but all in vain. She, 
however, perceiving that one of her teeth was decayed, had it taken out. 
It was believed that the cause of the malady had thus been found and 
removed; but an hour later the pain began again with the same violence 
as before, continuing for some months; after this it ceased of itself. 
On the return of the pain, later on, in all its former intensity, the patient 
consulted the very able surgeon Petit, who advised her to see Fauchard, 
as possibly the malady might have its cause and point of departure in 
some bad tooth. Fauchard found one of the inferior molars decayed. 
This being extracted, the pain promptly ceased, not to return any more.' 

Chapter XXXV contains twelve cases of serious maladies arising 
from dental diseases. One of these cases was observed in a patient 
aged fifty-seven years, who in consequence of caries of the last inferior 
molar on the right lost through necrosis a considerable portion of the 
lower jaw, including the whole of the. right condyle; he was affected, 

» Page 397. » Page 41 1. » Page 418. 


besides, with caries of the temporal bone, in so advanced a degree that 
the probe could reach the dura mater; he was, therefore, in serious 
danger of his life, had to undergo several surgical operations of exceptional 
gravity, and even after recovery remained permanently subject to various 
disturbances, such as a salivary fistula, paralysis of the lower eyelid, etc. 
And all this because the surgeons whom the patient had called in had 
directed all their attention to the secondary facts, instead of suppressing 
the primary cause of the evil, represented by a dental affection. 

A case observed by the surgeon Juton and communicated by him to 
the author is also a very important one. The patient was suffering with 
a large abscess on the right side of the lower jaw, accompanied by such 
great swelling of the cheek that it was impossible to open the mouth wide 
enough to examine the teeth. Juton proposed opening the abscess 
immediately, but the patient would not consent. The following day 
he was sent for in great haste. The gathering had changed its seat, 
making its way between the skin and muscles of the neck, where it now 
formed so huge a tumefaction that the patient was in danger of being 
suffocated. The abscess was now immediately opened, but the swelling 
of the face still persisted; it was therefore only after a month had elapsed 
that it was possible to extract the root of the last molar, which had been 
the original cause of the whole malady. The surgeon observed that the 
liquid injected into the fistulous opening in the neck issued from the 
alveolus of the last molar. After the extraction of the root a prompt 
recovery was effected.^ 

The second volume of Fauchard's work is entirely devoted to operative 
dentistry and prosthesis. 

Before speaking of the modes of cleaning, filing, and stopping the 
teeth, the author combats the opinion maintained by some, that these 
operations are in part useless, in part also dangerous, as having the effect 
of loosening the teeth, of depriving them of their enamel, and ruining 

Fauchard then describes the instruments proper for detaching the 
tartar;^ he speaks of the method to be followed in cleaning the teeth in 
order to not endanger the enamel;^ he speaks of the different kinds of 
dental files, of their different uses in relation to the various cases and 
indications; of the precautions to be taken in making use of them;* of 
the instruments to be used for scraping and cleaning the carious cavities 
and of the mode of employing them.'^ 

All of the above-named instruments are illustrated by figures, in con- 
templating which one cannot but reflect on the inferiority of the instru- 
ments then in use as compared with those of the present day. The greater 

* Chap, xxxviii, p. 481. ' Vol. ii, chap. ii. ' Chap. iii. * Chap. iv. » Chap. v. 


admiration is therefore due to Fauchard's talent, which, in spite of such 
imperfect and at times absolutely primitive means, enabled him to obtain 
the brilliant results cited in his observations. 

Chapter VI is dedicated to the stopping of decayed teeth. The 
sole materials used by the author for stopping were lead, tin, and gold. 

for detaching dental tartar (Kauchard). 

"Fine tin," he says, "is preferable to lead, for lead turns black much 
more easily and is much less durable; both are preferable to gold, because 
lighter and adapting themselves better to the unevenness of the carious 
cavities. Besides, gold being dear, not everyone can or will make the 
corresponding outlay." The author here adds that those who, from 


vanity or because possessed by the opinion that gold has special virtues, 
will not have their tooth stopped except with it, not unfrequently find 
dentists who, as the saying goes, content them and cozen them by using 
leaf tin or lead colored yellow, and making them pay for it as gold 

Fig. 8o 

Some of the denial files used by Fauchard. The little square figure represents a s 
grooved wedge destined to be inserted in large interdental spaces. In order to give i 
firmness to the teeth to be filed. 

The leaf metals were introduced and compressed into the carious 
cavities by means of three kinds of pluggers, which would nowadays 
be considered altogether insufficient and unfit for the purpose, but which 
then, nevertheless, served to produce excellent stoppings. The author 
speaks' of a lead stopping which had lasted in perfect condition for forty 

• Vol. ii. p. 71. 


Before stopping the tooth the cavity was scraped and its opening 
widened, if necessary, but no special form was given to the cavity itself, 
as is done at the present day. 

As at that time the state of the dental pulp was not taken into considera- 
tion before stopping a tooth, it often occurred that the stopping caused 
violent pain, which rendered its removal necessary.' 

Fauchard says that " if the sensibility of the carious cavity be too great, 
the lead ought only to be pressed in very lightly at first, then after one or 

' Vol. li, p. 77- 


two days a little more, continuing thus until it is properly compressed 
and fitted in, always provided, of course, that the pain does not increase. 
The sensitive parts of the tooth become thus more easily used to the press- 
ure of the lead, and the pain is in this manner avoided or moderated.'" 

Three instruments for plugging teeth. The two small figures represent silver plates 
for straightening teeth (Fauchard). 

The author also makes the remark' that sometimes, in scraping a carious 
cavity, "it is not possible to avoid uncovering and touching the nerve 
with the instruments; one becomes aware of this by the pain caused, and 
better still by a little blood issuing from the dental vessels." In such 

' Vol. ii, p. 78. • Ibid. 


cases, Fauchard advises stopping of the tooth immediately, for if it be 
carried out with delay, it is sure to be followed by inflammation and 
great pain, rendering necessary the removal of the lead or even the 
extraction of the tooth. 

Fig. 83 

>nd of which i: 
e outward (Fauchard). 

Cauterization of the teeth' continued to be much used in Fauchard's 
time, and this is very easily explainable when one considers that there 
was not then any other means of destroying the dental pulp. In making 
use of the actual cautery, the immediate end in view was to cause the 
cessation of obstinate toothache. "When the teeth give great pain and 
no relief is to be derived from the use of other remedies, one ought to 
cauterize the caries after having removed the extraneous substances that 

■ Chap. vii. 


may eventually be found in the carious cavity. After the cauterization 
one scrapes the cavity and fills it up with cotton-wool soaked in oil of 
cinnamon. Later on one stops the tooth.'" 

Fig. 84 

An extracting instrument calletl by Fauchard lever or tirtolre, and the handle of a 
pelican without the hooks. 

The chapter in which Fauchard treats of the correction of dental 
irregularities is of particular interest. In speaking of his observations, 
we have already seen that in this field also he knew how to obtain splendid 
and admirable results. He, nevenheless, made use of the most simple 


means — the file, pressure with the fingers, common threads or silk ones, 
little plates of silver or gold. At times, for straightening teeth, he made 
use of the pelican and the straight pincers, afterward tying the teeth in 

Fig. 85 Fig. 86 

Fauchatd's simple pelican (with Fauchard's double pelican, 

one changeable hook). 

their normal position. He rarely had recourse to extraction as a means 
i»f carrying out dental corrections.* 

To steady loose teeth,' Fauchard, as did the ancients, made use of gold 

' Vol. ii, chap, viii, p. 87. 

'Oiap. ix, p. 117. 


threads. When the spaces separating a loose tooth from the neighboring 
ones were too large, he introduced small pieces of hippopotamus ivory into 
them of about the height of a line, and not exceeding the tooth itself in 
thickness; on each side of these was a vertical groove destined to serve 
as a support to the next tooth. Each of these pieces was furnished 

Fig. 87 

Dental forceps (Fauch, 

with two holes, through which were passed the gold threads which served 
to bind together the teeth and the piece of ivory itself. This latter was 
fixed close down to the gum. 

Fauchard occupies himself in three different chapters (X, XI, XII) 
at great length with the extraction of teeth. He describes a pelican of 



^ (iwn invention, and speaks of the advantages it presents over other 
s previously in use. Notwithstanding this, it cannot be said 
ill the Instruments used by Faucbard for extracting teeth and roots 
Sttw a sensible improvement on those in use before his time. 

bill fortcps (Fauchard) 

Among the most usual operations, the author enumerates transplant;i- 
tion and especially replantation of the teeth.' Whenever, says Fauchard, 

' Speaking of transplantation, he says: "On voit par des cxpvricncfS journalitrvs i|ul' 
dea denes transplantees d'un alveole dans I'alveole d'une bouche difTerente sc sont conwrvecs 
plusieurs annees fermes et solides sans recevoir acune alteration, i-t servant a toutes Wn func- 
tions auxqudles Its dents sont proprcs." (Vol. ii, p. i8;.) 


• a wrong tooth is extracted by accident, it ought to be immediately 
replanted, and the same ought to be done when violent pain renders it 
necessary to extract a tooth that is not much decayed, as the patient is 
thus relieved without losing the tooth.' Fauchard adds that this opera- 
tion succeeds excellently in the case of incisors and canines, and very 
often, too, with small molars. 

Cutting forceps (Fauchard). Cutting forceps (Fauchard). 

After having spoken of transplantation, he says:' "There is another 
mode of replacing human or natural teeth which I have never yet seen 
used except by a provincial dentist whose name I ignore," This special 
method consists in the transplantation of a tooth — it matters little whether 
recently extracted or not — after having made three or four notches in 

•Page 188. 'Vol. ii, p. 191. 


its root of about a line in depth. The author goes on to describe all the 
particularities of the operation, and then adds: "After twenty-five or 
thirty days one removes the thread, and the tooth is found to be firm in 
the alveolus, owing to the fact that this latter, exercising a pressure on the 

Fig. 91 

Pincers used by Fauchard in the operation of lying teeth with gold wire. The three 
larger Bgures represent natural or artificial teeth in which holes and horizontal grooves 
have been made in order to fix them with gold threads. The two smaller represent 
pieces of hippopotamus ivory with a vertical groove on each side, destined to (ill large 
interdental spaces and to steady loose teeth by means of gold ligatures. 

root on every side, becomes perfectly moulded upon it. In this manner, 
the tooth will remain mortised, and may be preserved for a considerable 

This method, invented by an unknown provincial dentist, has been 
recently applied by Znamenski, of Moscow, for the implantation of arti- 
ficial teeth made of porcelain, of caoutchouc, or gutta-percha. 


One of Fauchard's greatest merits consists in the improvements intro- 
duced by him in dental prosthesis and in his having, besides, been the 
first to treat of this most important part of dental art in a clear and 
particularized manner. 

The materials then most used in dental prosthesis were human teeth, 
hippopotamus tusks, ivory of the best quality, and ox-bone.^ 

The author minutely describes the methods to be followed to repair 
dental losses in every possible case and of whatever extent. 

According to the circumstances, Fauchard used, for maintaining arti- 
ficial teeth in their place, linen, silk, or gold thread, passed through holes 
made in them, and tied to the natural teeth. 

When a set of two, three, four, or more teeth was to be applied, Fauchard 
first prepared them separately and then united them together by means of 
one or two threads of gold or silver in such a manner that the set formed 
at last a single piece, which was then fixed to the natural teeth. When the 
piece consisted of several teeth it was reinforced with a small plate of 
gold or silver fixed to its inside by means of small tacks of the same metal 
riveted on one side to the plate, on the other to the front part of each tooth. 

The author remarks that a similar prosthetic piece lasted longer than 
those previously described, but required proportionately much more work 
and much greater expense. He adds that, by employing this plate, one 
can even dispense with threading and fixing the teeth together with gold 
or silver wire; but that it was then necessary to make a horizontal groove 
at the back of each tooth corresponding to the width and thickness of the 
plate, which could be fitted into the serial groove and fixed to each single 
tooth by means of two small rivets.^ 

At other times the prosthesis was carried out in a single piece of material 
(ivory, hippopotamus tusk, etc.) that was carved in such a manner as to 
substitute exactly the teeth wanting, it being fixed to the natural teeth 
in the usual manner. 

Fauchard sometimes left the dental roots in their place (if they were in 
good condition), applying upon them artificial crowns, which he either 
bound to the neighboring teeth or fixed with screws to the respective roots. 

** When one wishes to apply an artificial crown to the root of a natural 
tooth, one files away the part of the root that emerges above the gum, and 
even more if possible. One then removes, with proper instruments, all 
that is decayed in the root itself; after which one stops the root canal with 
lead and fits the base of the artificial tooth to the root in such a manner 
that they correspond perfectly to each other. One drills one or two holes 
in the tooth through which to pass the ends of a thread, which serves 
to fasten it to the natural teeth on each side of it, as described above. 

• Vol. ii, chap, xiii, p. 215. * Vol. ii, pp. 217 to 224. 


"If the root canal has been very considerably enlarged by the carious 
process, so as to have rendered it necessary to stop it, the root being, 
nevertheless, still quite steady, one bores a small hole in the lead as deep 
and as straight as possible, without, however, penetrating farther down 
than the root canal. The artificial crown is then united to the root by 
a pivot in the manner I shall now describe."* 

The method of applying pivot teeth is described with great accuracy. 
In it the author considers all the different circumstances that may present 
themselves, and says, among other things, that if the root is still sensitive 
to pain, one should apply the actual cautery inside the canal, before 
fitting the artificial crown to the root. For fixing the pivot inside the 
artificial crown (which was generally the crown of a human tooth), 
Fauchard used a special cement made with gum lac, Venetian turpentine, 
and powdered white coral. ^ 

In the case of there not being any whole teeth to which the prosthetic 
piece would be fixed, but only roots, Fauchard made two holes in it in 
perfect correspondence with the canals of two roots, and fixed the pros- 
thetic piece to these by means of two pyramidal screws.' 

This method suggests in a certain way the idea of bridge-work. 

In Chapters XVII, XVIII, XXIV, and XXV, Fauchard describes 
various methods for the application of entire sets of false teeth, both upper 
and lower, as well as double. 

The author says that if ihe lower jaw is entirely toothless, a set of 
teeth can be adapted thereto without the need of any special contrivance; 
however, it is necessary that the prosthetic piece should fit perfectly, so 
that the configuration of the maxillary arch and the irregularities of the 
gum, finding themselves in complete correspondence with the piece itself, 
may keep it steady in its place. The support offered by the tongue 
interiorly, by the cheeks and the under lip exteriorly, contributes to keep 
the artificial set steady; one can thus masticate as easily with it as with 
one's own teeth, especially if the teeth of the upper jaw be still existing 
and the individual be already sufficiently used to the wearing of it.* 

With regard to the application of an entire set of upper teeth, one learns 
from Fauchard that although some attempt had been made in this direc- 
tion before this time, the results had been very unsatisfactory. He 
relates that: **In 1737 a lady of high rank, of about the age of sixty, who 
had not lost any of her lower teeth, but was deprived entirely of the upper 
ones, applied to M. Caperon, dentist to the King, who was most able in 
his profession, in the hope that he might be able to furnish her mouth 
with an upper set. But he said that, no tooth whatever being left in 

* Vol. ii, p. 225. * Vol. ii, p. 229. 

' Chap, xvi, pp. 252, 255. * Vol. ii, chap, xvii, p. 260. 


existence, every possible point of attachment was wanting, and it would 
therefore be as difficult to do this as it would be to build in the air."' He, 
however, directed the lady to Fauchard, who asked for a few days to think 
the matter over, and succeeded in devising a means of applying an 

Fig. 92 

Complete dentures (Fauchard). /. 3 represents an enamelled denture with aitiliciil 
gums; /. 4 and /. 5, steel springs. 

upper set of teeth, which, in fact, entirely satisfied the wishes and wants 
of the client. "As this lady," says the author, "simply wished to have the 
front of her mouth decorated, and to be able to pronounce more perfectly, 

' Vol. ii, chap. ! 

'. P- 339- 


I gave less extension to the set. The lady eats easily with it and could 
not now do without it. For greater convenience she has two similar 
sets, which she uses alternately.'" 

The author describes with great minuteness the manner in which the 
prosthetic apparatus in question was constructed and supported, and then 

Fig. 93 

e supported by springs tixei 
natural teeth of the lo^ 

to a gold appliance which e 
I jaw (Fauchard). 

speaks of the successive improvements introduced by him into this most 
important part of prosthetic dentistry, particularly in what regards the 
springs destined for the support of the upper set of teeth. 

Fauchard also relates having made an attempt to apply an upper set 
of teeth without the aid of springs, which proved successful in three cases. 
"One can," says he, "adopt an entire set of teeth to the upper jaw, of 



much greater simplicity than those described, and which is maintained in 
its place by the sole support of the cheeks and the lower teeth. It must 
be very light indeed and serves almost solely to improve the appearance 
and the pronunciation; but when the individual gets used to it, he can also 
masticate with it. A set of teeth of this kind ought to adhere well to the 

A spring denture for a case in which the lower front teeth still exist. Figs, i to 6, 

various parts of the apparatus (Fauchard). 

gums and to be constructed in such a manner that the cheeks may afford 
it sufficient pressure and support together with the aid of the lower teeth; 
these latter sometimes bring it back into its place, without anyone per- 
ceiving the movement except the wearer himself. Not long since I had 
to renovate a set of teeth of this kind made by me more than twenty- 


four years ago, and worn by the owner to the greatest advantage. I 
have since made two others which have proved most useful to the persons 
wearing them. It is true that there are few mouths adapted for wearing 
these sets, so much so that, excepting the three referred to, I have never 
made any others. To be able to construct similar sets successfully, the 
dentist must be possessed of skill and ingenuity. Apart from this, they 
are the most suitable for persons who cannot spend much, as they cost 
less to make.'*^ 

Fauchard did not merely content himself with having perfected dental 
prosthesis in the manner alluded to; he also succeeded in giving a quite 
natural appearance to artificial teeth. To reach this end he placed the 
art of the enameller under contribution to the dental art. Thus he had 
artificial pieces covered over with enamel, imparting to them the hue 
that seemed to him best adapted, and also imitating admirably the natural 
color of the gums, so as to render the illusion perfect. The pieces to be 
enamelled were worked by special rules, which are minutely given in 
Chapter XIX of the second volume of his book. 

Fauchard also brought the palatine prosthesis to a high degree of per- 
fection. He describes five different obturators of the palate, which of 
themselves alone would be sufficient to testify to the highly inventive 
genius of the author, although they are defective in being somewhat too 
complicated. Some of these fixtures are a combination of a dental set 
and palatine obturator. 

We ought now to mention, in the order of chronology, some authors of 
lesser importance. 

Vasse and De Diest wrote about the danger of fatal hemorrhage 
following on dental operations.^ They report a few cases of this kind, 
giving the blame of these accidents, however, to the carelessness of the 

Lavini published in Florence, in the year 1740, a very good treatise 
on dentistry {Trattato sopra la qualita Je* dentiy col mo Jo di cavarliy 
mantenerli e fortijxcarli)^ which, however, marks no advance on the work 
of Fauchard. 

M. BuNON (died 1749), a French dentist, wrote four admirable works 
on dentistry, which were published from 1741 to 1744. We will here 
briefly allude to the most salient ideas therein contained. 

This author combated strenuously some prejudices then generally 
difl^used; such as that of its not being advisable to extract teeth during 
pregnancy, and that of the extraction of an upper canine (eye tooth) being 

» Vol. ii, p. 353. 

' Jean de Diest, An haemorrhage ex dentium evulsione chirurgi incuria lethalis? Paris, 
1735. David Vasse, Hsemorrhagia ex dentium evulsione, chirurgi incuria lethalis, Paris, 



attended with great danger. He demonstrated the absurdity of the 
latter idea by putting in evidence the anatomical fact that the upper 
canines are innervated by the infraorbital nerve, which does not stand in 
any relation whatever to the organ of sight.^ 

Among the other remedies recommended by him against the disorders 
and perils of first dentition, there is one most curious, not to say ridiculous: 
he advises rubbing the nape of the neck, the shoulders, the back, and the 
lower limbs of the child, but in doing this the friction should proceed 
from above downward, in order to offer resistance to the flow of humors 
toward the upper parts of the body. The utility and efliicacy of this kind 
of massage in favoring the process of dentition seems, of a truth, very 
open to question. 

Bunon speaks at length of erosion of the teethy and declares himself to 
be the discoverer of this disease, which destroys the enamel of the teeth 
already before their eruption. The first molars, the canines, and the 
incisors are much more frequently damaged and aflPected by it than the 
other teeth. According to Bunon, it is generally due to measles, smallpox, 
malignant fevers, or scurvy, when children are subject to these maladies 
during dentition, and more especially during the first. He is of the opinion 
that erosion not only generates caries, but may be considered as being the 
origin of the greater part of dental aflPections. 

This author distinguishes three principal kinds of dental tartar, the 
black, the pale yellow, and the brownish yellow; he admits, however, 
two other kinds that are less frequent, that is, the red tartar and the green. 

He relates having observed in the jaw of a child, who died at the age 
of three years and a half, a splintering of the alveolar parietes in all 
directions, and attributes this phenomena to disproportion between the 
size of the teeth and the alveoli. On the basis of his anatomical observa- 
tions, he says that caries only appears on teeth that have already come out 
of the gums, whilst erosion is produced in teeth not yet erupted, indeed, 
at times, several years previous to their eruption. 

We will also mention, by way of a curiosity, Bunon's proposal to sub- 
stitute the word legs for that of dental roots. ^ 

Fr. a. Gerauldy, a French dentist, wrote (1737) an excellent treatise 
on dental maladies and on the mode of preserving the teeth. His book, 
which was also translated into German,' contributed to the diflPusion of 
knowledge relative to dental prophylaxis and therapeutics, but apart from 
this brought no increment to the progress of practical dentistry. Some 

* M. Bunon, Sur un prejuge tres-pemicieux, concernant les maux de dents qui sur- 
viennent aux femmes grosses, Paris, 1741. 

^ M. Bunon, Essai sur les maladies des dents, Paris, 1743. Experiences et demonstra- 
tions pour servir de suite et de preuves a Tessai sur les maladies des dents, Paris, 1746. 

' Abhandlung von Zahnkrankheiten, etc., Strassburg, 1754. 


of the ideas of the author, however, merit consideration. He clearly 
expresses the opinion that the shedding of the milk teeth is brought about 
by the pressure exercised upon them by the germs of the permanent teeth 
in course of development. The loss of the teeth in young subjects, or in 
those who have not yet reached forty years of age, is explained by the 
author in an altogether special manner. He relates that Louis XIV, at 
the age of thirty-five, had lost all his upper teeth, and the considerations 
he makes on the subject bring him to the conclusion that the precocious 
loss of the upper teeth depends in many cases on a paralysis of the nervous 
fibers that go to them, which paralysis is probably caused by a dissolute 
and intemperate life, having as its consequence the weakening of the organ- 
ism and, above all, of the nervous system. Without doubt there is some 
truth in Gerauldy's ideas, it being well known that the falling of the teeth 
(as well as of the nails and the hair) often depends on nutritive disorders 
deriving from nervous disturbances. We have the clear proof of this in 
certain cases of tabes dorsalis accompanied by the spontaneous falling 
of the teeth and nails. 

Joseph Hurlock, an Englishman, published a treatise in 1742,^ in 
which he warmly recommends lancing the gums in cases of difficult 
dentition; he declares this to be entirely without danger, and affirms that 
it constitutes the sole means of salvation for not a few infants who without 
it would die of convulsions. 

MouTON, in 1746, that is, in the same year in which the second edition 
of Fauchard's work was issued, gave to the light a monograph, the 
first extant, on mechanical dentistry.^ The methods of this author for 
the most part do not differ from those of Fauchard, nevertheless one 
finds several important innovations in his work. To prevent the further 
deterioration of teeth already much destroyed, and to preserve them some 
time longer, Mouton had recourse to the application of "calottes d'or," 
that is, gold crowns. He used this for the front teefth as well as for the 
molars, but in the former case he had them enamelled to give them the 
same appearance as natural teeth. 

Mouton also invented a new method of applying artificial teeth. Up to 
then the ordinary method had been that of fixing them to the natural 
teeth by means of threads passed through holes made in the artificial teeth 
expressly for that purpose. Mouton is the first to speak of artificial 
teeth fixed to the natural teeth adjoining them by means of springs 
or clasps. 

This author relates having carried out several transplantations with 
perfect success, a thing that contributed greatly to his renown not only 
in France, but also in England. He distinguished himself, besides, by the 

' A Praaical Treatise upon Dentition or the Breeding of the Teeth in Children. 
' Essai d'Odontotechnique, ou Dissertation sur les Dents Artificielles. 


correction of dental irregularities. Lastly, it is to be noted that this 
author frequently had recourse, as a remedy against toothache, to the 
stretching of the dental nerve by means of moving and partially raising 
the tooth (subluxation). 

A. Westphal. In proof of the great utility of lancing the gums in 
cases of difficult dentition, A. Westphal reports a case in which the difficult 
eruption of an upper canine tooth provoked considerable inflammation 
and protrusion of the eye on the same side as the tooth; these symptoms 
promptly disappeared, however, as soon as the gum was lanced down to 
the tooth itself.^ 

J. Bertin also declares himself in favor of this operation; he recom- 
mends never to neglect it in cases of difficult dentition, and to make the 
said incisions deep and wide enough.^ 

L. H. RuNGE, a surgeon of Bremen, published, in 1750, a monograph on 
the diseases of the frontal and maxillary sinuses. He says that in cases 
of inflammation of Highmore's antrum, the pus may make its way, cor- 
roding the bone, as far as the alveoli, or, sometimes, as far as the orbital 
cavity; and, Wr^* versa^ alveolar suppuration can give rise, by diffusion, 
to abscess of the maxillary sinus. In this latter, tumors of various kinds 
may form (polypi, cysts, sarcomas, cancers, exostosis), the existence of 
which is ignored at first, and only becomes manifest tardily. Runge's 
father, who was also a surgeon, had occasion to observe, and to treat 
an important case of disease of the maxillary sinus, with considerable 
dilatation of the same, not only on the side of the cheek, but also on the 
side of the palate and of the nasal fossae. With a strong scalpel he per- 
forated the outer wall of the antrum above the molars (keeping the cheek 
detached) and enlarged the aperture by making the instrument turn 
around on its own axis, thus giving exit to a considerable quantity of non- 
purulent liquid. Detersive and aromatic injections were used for some 
time. The canine tooth, situated obliquely, having been extracted, its 
alveolus was found to communicate with the antrum. From this moment, 
the injections being continued, a rapid improvement was obtained and the 
patient was so completely cured that no deformity of the face remained. 

Runge relates a case in which, having extracted a canine tooth, he found 
a cyst adhering to its root. From this he is induced to believe that in the 
case related above the disorder was also to be attributed to a large cyst 
having its origin in the root of the canine. 

According to him, the ozena always stands in relation to a suppurative 
affection of the maxillary sinus, and for its treatment one must, therefore, 
have recourse to Drake's operations.^ 

* Sprengcl, Part ii, p, 319. ^ Journal de Medecine, 1756. 

' L. H. Runge. Dc Morbis sinuum ossis frontis, maxillx superioris, etc., Rintel, 1750. 


Georg Heurmann, a surgeon in Copenhagen, recommends making 
use, after the Cowper-Drake operation, of a small cannula in order to 
facilitate the exit of the pathological material contained in the sinus, and 
also to render it easier to introduce into it medicated or detersive sub- 

Lecluse. One of the most celebrated French dentists of the eighteenth 
century is Lecluse. Dental literature was enriched by him with several 
works, partly written in popular style, partly addressed to dental special- 
ists. In 1750 he published his Traite utile au public^ oh Von enseigne 
la methode de remedier aux douleurs et aux accidents qui precedent et qui 
accompagnent la sortie des premieres dents y de procurer un arrangement 
aux secondeSy enfin de les entretenir et de les conserver pendant le cours 
de la vie. The work seems to have been very favorably received, as its 
first edition, printed in Nancy, was followed by a second, printed in Paris, 
only four years later. In 1755 he published another book: Eclair- 
ctssements essentiels pour parvenir a preserver les dents de la carie et le 
conserver jusqua Vextreme vieillesse. But the most important of his 
works is the Nouveaux elements d'odontologie^^ the first edition of which 
was published in 1754, and followed by a second in 1782. 

We do not enter into a minute examination of these works, which, 
taken altogether, do not contain anything very new. We will only remark 
that Lecluse treated in a succinct but correct manner the anatomy of 
the mouth; invented some and perfected other instruments, the most 
important of which is the elevator that still bears his name, and finally, 
that he frequently performed the operation of replantation, warmly 
recommended by him as an excellent means of cure in certain cases of 
caries. The extracted tooth was stopped and afterward replanted, and, 
says Lecluse, became fast within eight days, proving as serviceable as a 
perfectly healthy tooth, and never again causing any pain. 

Philip Pfaff, dentist to Frederick the Great, King of Prussia, was the 
first among the Germans who wrote a real treatise on dentistry. His 
book' contains, in 184 succinctly but well-written pages, the anatomical 
and physiological notions relative to the teeth, as well as all that belongs 
to dental pathology, therapy, and prosthesis. 

Besides a few observations about supernumerary teeth, PfafF relates 
several cases in which the incisors, inferior as well as superior, were 
renewed (twice consecutively), that is, once at the usual epoch, and the 

* Sprengel, Part ii ( ?), p. 322. 

' Nouveau elements d'Odontologie, contenant Tanatomie de la bouche, ou la description 
de toutes les parties qui la composent, et de leur usage; et la pratique abregee du dentiste, 
avec plusieurs observations, par M. Lecluse, Chirurgien dentiste de Sa Majeste le Roi de 
Pologne, etc., Paris, 1754 (vol. in i2mo of pages viii-222 with six plates). 

' Abhandlung von den Zahnen des menschlichen Korpers und deren Krankheiten, 1756. 


second time between the seventh and thirteenth years. He also cites 
from the anatomical tables of Kulmus the following epitaph in low Latin, 
that seems to allude to a case of third dentition: 

"Decanus in Kirchberg, sine dente canus, ut anus 
Interum dentescit, ter juvenescit, hie requiescit." 

In cases of hemorrhage ensuing on the extraction of teeth, the best 
hemostatic, according to PfafF, is essence of turpentine, a remedy which 
in these cases he had always found efficient. He introduced a little ball 
of lint bathed in this essence as deeply as possible into the alveolus, apply- 
ing upon it some blotting paper reduced to pulp or some dry lint that the 
patient compressed tightly by closing his teeth. 

Gingival abscesses as well as fistulae of the maxillary region almost 
always owe their origin, says PfafF, to decayed teeth, and can, therefore, 
in general, not be cured except by the extraction of these teeth. 

The prosthetic methods described by this author are, for the most part, 
identical with those of Fauchard and the other French dentists already 
mentioned. As to the materials used for prosthesis at different periods, 
PfafF mentions, besides ivory, bone, hippopotamus tusk, teeth of sea cow, 
and human teeth, also teeth made of silver, of mother of pearl, and 
even of copper enamelled. 

The chief merit one must concede to Philip PfafF is that of having been 
the first to make use of plaster models. It is, therefore, to two Germans 
— PfafF and Purmann, the latter who, as we have already seen, used wax 
models — ^that one of the greatest progressive movements in dental pros- 
thesis is indebted, that is, the method of taking casts and making models, 
of which method one finds no trace whatever in the authors of antiquity, 
and which, it would appear, was not known even to Fauchard himself. 
The wax casts of an entire jaw were taken by PfafF in two pieces, one of the 
right half of the jaw, and the other of the left; which were then reunited, 
and one thus avoided spoiling the cast in removing it from the mouth. 

Another great merit of Philip PfafF is that of having first carried out 
the capping of an exposed dental pulp, previous to stopping a tooth. 

Notwithstanding this, PfafF is not the first who, as Geist-Jacobi is 
inclined to believe,^ had dared to apply a filling over an exposed dental 
pulp without first cauterizing it. As we have already seen, Fauchard did 
not hesitate in the least to fill a tooth when the dental pulp had become 
exposed in scraping the carious cavity. But the French dentist carried 
out, with much delicacy, a simple filling, whilst PfafF first capped the 
dental nerve. 

Jacob Christian Schaffer. In 1757 the evangelical pastor, J. Ch. 
SchafFer (we do not know if he was at the same time a dentist, or merely an 

* Geist-Jacobi, p. 164. 


amateur in odontology), wrote a little book^ to disprove the existence 
of worms in decayed teeth, and to show the fallacy of believing that the 

* Die eingebildeten wiirmer in Zahnen, Regenburg, 1757. 

[SchafFer's publication is of considerable interest in that his illustration here repro- 
duced exhibits one of the devices somewhat generally employed for the eradication of 
dental worms as a cure for toothache. In the title of his work SchafFer describes himself 
as Protestant preacher at Regensburg, member of the Royal Society of Fine Arts at 
Gottingen, of the Royal Society of Science at Duisberg, honorary member of the Fine 
Arts at Leipsic. 

The several details of the plate are designated as follows: 

Fig. I. The supposed worms, with single and double tails, or actually seed buds of 
the henbane driven out by heat, natural size. 

Fig. II. Kidney-shaped seed of the henbane, natural size, without seed buds. 

Fig. III. Another such seed, natural size, with the pith being driven out in bow- 

Figs. IV and V. Slightly magnified supposed entrails of the tooth worms, actually the 
inner basis substance for the development of the seed lobes. 

Fig. VI. Portion of the skin and driven out supposed entrails of the tooth worms, 
strongly magnified: {aa) skin still attached; {b) supposed entrails. 

Fig. VII. Seed same as Fig. II, magnified: {a) external pellicle; {b) seed bud. 

Fig. VIII. Seed of Fig. Ill, magnified: {aa) external pellicle; {b) node; (r) seed 
bud driven out in bow-shape. 

Figs. IX, X, and XI. Three kinds of supposed tooth worms, magnified; the lettering 
corresponds in all three: {a) head; (b) brown spot or mouth; (r) body; {J) apparent 
opening or anus; {ee) single or double tail; {ff) brown spot of the tail; also an apparent 

Fig. XII. Representation of the utensils and the mode in which they are arranged 
during the application of the supF>osed remedy against tooth worms: {a) earthen pot; 
{b) opening visible on one side; (f) opening in the bottom; {dd) iron passing through 
the two side openings, on which the wax balls (containing henbane seeds) are laid inside 
the pot; {e) smoke arising through the opening in the top, which is directed into the 
mouth; {ff) bowl of water in which the pot is set, into which the supposed worms fall 
and in which they are found after the cure. 

It would seem not at all improbable that the inhalation of vapors arising from heated 
henbane seeds might in some cases, e.g.y of odontalgia from pulpitis, produce a sedative effect 
by the action of the hyoscyamine given off. Assuming that the method possessed even a 
slight therapeutic value, that factor in connection with the apparently tangible evidence 
of the existence of tooth worms which it afforded to the ignorant, makes the method a 
most interesting example of the way in which superstition and ignorance about medical 
matters are kept alive and sustained by a very slight increment of truth. 

Another interesting reference to the use of henbane seeds for the cure of toothache by 
fumigation as found in an old Saxon manuscript of the ninth or tenth century, a transla- 
tion of which is published in Leechdoms, Worthcunning, and Starcraft of Early England, 
vol. ii, p. 51, a collection of documents illustrating the history of science in England 
before the Norman conquest, published under direction of the Master of the Rolls. 
The reference is as follows: 

" For tooth wark, if a worm eat the toothy take an old holly leaf and one of the lower 
umbels of hartwort and the upward part of sage, boil two doles (that is, two of worts to 
one of water) in water, pour into a bowl and yawn over it, then the worms shall fall into 


supposed worms may be made to drop out by means of fumigations of 
henbane seeds. His book appeared, as a matter of fact, rather behind- 

the bowl. If a worm eat the teeth, take holly rind over a year old, and root of Carhne 
thistle, boil in so hot vialtr! Hold in the mouth as hot as thou hottest may. For tooth 


worms, take acorn meal and henbane seed and wax, of all equally much, mingle theie 
together, work into a wax candle and burn it, let it reek into the mouth, put a black 
cloth under, then will the worms fall on it." — E. C. K.] 


hand, for in it SchafFer repeats in substance what HouUier had already 
said two centuries earlier, and after him various other authors, including 
Fauchard. At any rate, to cooperate in the complete destruction of error 
and in the diffusion of truth is always laudable. We feel, however, 
bound to add that in the very same year in which SchafFer's pamphlet 
was published, Dufour, a Frenchman, described a worm that had been 
taken out of a decayed tooth, and called attention to the fact that it was 
altogether different from the "dental worms'* described by Andry/ 

BouRDET. An excellent book on dentistry* appeared in France in the 
year 1757, the work of Bourdet, a celebrated dentist and elegant writer, 
in whom the gifts of literary and scientific culture were coupled with a 
vast experience and a profound spirit of observation. His merits pro- 
cured him the honor of being appointed dentist to the King. 

This author condemns as harmful the use of hard substances (such as 
bone rings, etc.) that people are in the habit of putting into children's 
hands during the period of the first dentition, in the idea that by pressing 
these objects between the gums, as children instinctively do, they cut their 
eeth more easily. As to emollients, he holds them to be completely 
useless, and prefers to all these remedies the use of lemon juice. 

According to Bourdet, the teeth are so apt to decay, partly because of 
the frequent changes of temperature to which they are exposed, and 
partly because, differently from the bones, they are not provided with any 
protective organic covering. 

In many cases of caries, Bourdet extracted the tooth, filled it with lead 
or gold leaf, and replanted it; but if, in extracting, the alveolus had been 
somewhat injured (a thing very likely to happen with the instruments 
of the period), he replanted the tooth immediately, to preserve the alveolus 
from the damaging action of the air, and carried out the stopping at a 
later time. 

Even in certain cases of violent toothache not depending on caries, 
Bourdet luxated the tooth and replaced it in position directly. But as 
some dentists had accused him of having passed off as new an operation 
already made known by Mouton since the year 1746, Bourdet defended 
himself by saying that whilst Mouton only shook the tooth, raising it a 
little, simply to distend the nerve, he, instead, effected a complete luxation, 
in order altogether to interrupt the continuity of the nerve. Anyhow, 
this operation was not new, as it had already been recommended and 
practised by Peter Foreest, in the sixteenth century, and in an even more 
remote epoch by the Arabian surgeon Abulcasis. 

* Recueil periodique d 'observations de Medecine, Chirurgic, etc., par Vandermonde, 
Paris, 1757, Tome vii, p. 256. 

^ Recherches et observations sur toutes les parties de Tart du dentiste, 2 vols., Paris, 1757. 


Sometimes, when the permanent canine comes forth, it has not room 
enough, and therefore grows outward. In this case Bourdet extracts 
the first premolar; the canine then advances gradually of itself toward 
the space left by the extracted tooth, until it occupies its place exactly. 
He also counsels the extraction of the first premolar on the opposite side 
of the jaw, in order to preserve the perfect symmetry of the dental arch on 
both sides. When the arch formed by the jaws is too large and of an ugly 
appearance, Bourdet advises extracting the first upper and lower premolars, 
so that the maxillary arches may acquire a more regular form. In cases 
in which the defect of form exists only in the lower jaw, that is, in children 
who have protruding chins, Bourdet corrects this deformity by extracting 
the first lower molars shortly after their eruption, that is, toward seven 
years of age. In this manner, says the author, the lower jaw grows smaller 
and the deformity disappears. The inventor of this method, as Bourdet 
himself tells us, was the dentist Capuron. 

Bourdet made prosthetic pieces, whose base, representing the gums and 
the alveoli, was made entirely of gold and covered over with flesh-colored 
enamel on the outside, so as to simulate the natural appearance of the 
gums; the teeth were adjusted into the artificial alveoli and fixed with 
small pins. At other times he made use of a single piece of hippopotamus 
tusk, in which he carved not only the base, but also the three back teeth 
on each side, whilst the ten front teeth were human teeth fixed to the base 
with rivets. 

One of Bourdet's principal merits is that of having brought artificial 
plates to perfection by fixing them not, as heretofore, to the opening of the 
palate or inside the nose, but by means of lateral clasps fitted to the teeth. 

In a special pamphlet, published in 1764,^ Bourdet treats of the diseases 
of Highmore's antrum. To facilitate the exit of pathological humors 
from the sinus, after the Cowper operation, he introduced a small cannula, 
forked at one end, into the antrum and fixed the two branches of the fork 
to the neighboring teeth by tying. 

In some diseases of the maxillary sinus (polypus, sarcoma, etc.) Bourdet 
recommends cauterizing. 

Besides his principal work, the pamphlet on the diseases of Highmore's 
antrum, and some others of less importance, Bourdet wrote an excellent 
book on dental hygiene,^ which had the honor of two translations, one 
German, the other Italian; the latter published in Venice in 1773. 

This celebrated author inveighs bitterly against charlatans and quack 
dentists, and throws light on all their impostures. It appears, however, 
that in the midst of this despicable class, so justly condemned by him, 

^ Sur les depots du sinus maxillaire. 

' Soins faciles pour la propriete de la bouche et pour la conservation des dents, Paris, 1759. 


there existed a courageous though unscientific operator, to whom posterity 
would have attributed due honor had his name been handed down, 
for he was the first, in all probability, to try the implanting of teeth in 
artificial alveoli. This is, at least, what we deduce from a passage in one 
of Bourdet's works, in which we read that a charlatan sought to impose 
on the public the belief that he could make a hole in the jawbone and 
plant therein an expressly prepared artificial tooth, which in a brief space 
of time would become perfectly firm and as useful as a natural one. 
Bourdet adds that an attentive investigation led to the recognition of the 
said tooth being simply that of a sheep. It would appear, therefore, that 
the operation had been in reality performed, it matters but little whether 
with the tooth of a sheep or with one of another kind. 

JouRDAiN was another eminent writer on dental matters, at this period. 
Rather than a true surgeon-dentist like Fauchard and Bourdet, Jourdain 
was a general surgeon who had dedicated himself with particular predi- 
lection to the study and treatment of oral and maxillary diseases. And 
precisely for this reason his writings, although of great scientific impor- 
tance, are far from possessing for dental art, properly so-called, the same 
value as the works of Fauchard, Bourdet, and other great dentists of the 
eighteenth century. His works, as Geist-Jacobi justly observes, give us 
the impression of his having been a theorist rather than a practical dentist. 

In 1759 Jourdain described in the Journal de Medecine^ an improved 
pelican and another instrument to be used for straightening teeth inclined 
inward. Two years later he published his treatise on the diseases of 
Highmore's antrum and on fractures and caries of the maxillary bone.' 
After this, appeared his book on the formation of the teeth.' He therein 
describes with great accuracy the dental follicle from its first appearing 
to the moment of birth, following it throughout its evolution. This lengthy 
book is most interesting, for it is not a mere compilation, but gives the 
results of personal research and experience. But by far the most impor- 
tant of all the works of this author is his treatise on the diseases and 
surgical operations of the mouth.* This book went through several 
French editions, was translated into German in 1784, and has had, besides, 
two English editions in America of comparatively recent date, that is, 
at Baltimore in 1849, and at Philadelphia in 1851; all of which proves 

* Vol. X, pp. 47 to 148. 

^ Traite des depots dans le sinus maxillaire, des fractures et des caries de Tune et de I'autre 
machoire, Paris, 1761. 

' Essais sur la formation des dents, comparee avec celle des os, suivis de plusieurs experi- 
ences tant sur les os que sur les parties qui entrent dans leur constitution, Paris, 1766. 

^ Traite des maladies et des operations reellement chirurgicales de la bouche et des parties 
qui y correspondent, suivi de notes, d'observations, et de consultations interessantes, tant 
anciennes que modemes, 2 vols. 8vo, Paris, 1778. 


the great value of the work; it treats, however, much more of general 
surgery of the mouth and neighboring regions than of dental art properly 
so called. The first volume of 626 pages is almost entirely dedicated to 
the diseases of the maxillary sinus, which, for this author, were ever the 
object of favorite and particular study. He is not in favor of carrying out 
irrigation of the antrum through the mouth, even when an alveolar open- 
ing has resulted spontaneously through the extraction of a decayed tooth ; 
he prefers instead, whenever this is possible, the reopening of the nasal 
orifice, by means of sounds and cannulas adapted for the purpose, that is, 
varying in thickness and in length, and curved according to the necessities 
of the case. The natural opening of the antrum being reestablished, 
one irrigates the cavity through it by means of a cannula to which a small 
syringe has been screwed. When the teeth are sound, notwithstanding 
the diseased condition of the antrum, Jourdain is absolutely contrary to 
the performing of the Cowper-Drake operation. When, on the contrary, 
the malady owes its origin to decayed teeth, Jourdain extracts them, but, 
as already said, carries out the detersive and medicated injections through 
the natural opening. 

The author divides the collections of the maxillary sinus into purulent and 
lymphatic. The purulent are painful and corrode the bone, the lymphatic 
are not painful and do not corrode the bone, but distend and soften it, 
producing external tumefaction which yields to pressure, and, on this being 
diminished, gave out a characteristic sound. These so-called lymphatic 
gatherings referred to by Jourdain are none other than mucous cysts 
of the maxillary sinus. Also the other diseases of Highmore's antrum 
(polypi, etc.) are taken by this author into attentive and minute considera- 

The second part of the work is dedicated to the other diseases of the 
maxillary bones (especially of the inferior one), as well as to those of the 
lips, cheeks, salivary ducts, gums, frenum linguae, etc. Dental hemor- 
rhage and difficult dentition are also spoken of in this volume. 

The author relates, with regard to the latter subject, that he had 
observed, in corpses of infants who had succumbed to a difficult denti- 
tion, that the crowns of the erupting teeth were covered by the alveolar 
margins folded upon them. This, according to him, must be the reason why 
even lancing of the gums proves useless in some cases of difficult dentition; 
it is therefore necessary, whenever it is possible to recognize the existence 
of this state of things, to destroy the bony margins that oppose the erupting 
of the teeth; the author declares that he has frequently done this, with 
fortunate results. 

In 1784 Jourdain published a treatise on artificial dentures.* He 

' Reflexions et eclaircissements sur la construction et les usages des rateliers complets er 


therein specially speaks of a complete denture with four springs, per- 
fectly adapted to the purpose of mastication. The author attributes 
the merit of its invention to Massez, who had imagined it toward 1772. 
If we may judge, however, by what Joseph Linderer says,^ this denture 
appears to have been too complicated, even when compared with those 
described by Fauchard. 

Lamorier and Russel, contemporaries of Jourdain, also studied the 
diseases of the maxillary sinus, and published in the Memotres de V A cade- 
mie de Chirurgiey vol. iv, several important cases of polypi and other 
diseases of the antrum. Lamorier is not in favor of the Cowper-Drake 
operation. He recommends perforating the antrum immediately above 
the first molars, or rather between it and the malar bone. In this he 
seems to have been influenced by the considerations that the wall of the 
cavity here presents the least thickness, and that this is the most dependent 
part of the sinus. But he did not always deem it necessary to make a 
perforation here, when a fistulous opening had previously formed in some 
other place. His method of operating is as follows : The jaws being closed, 
the angle of the mouth is drawn outward and slightly upward with a curved 
instrument called by the author a speculum; this done, the gum is incised 
below the molar apophysis and the bone laid bare, and then pierced 
with a spear-pointed punch. The opening is afterward enlarged if found 

Several contributions to the knowledge of the diseases of the maxillary 
sinus and their treatment were made about this time by Beaupreau, 
Dubertrand, Caumont, Dupont, Chastanet, Doublet, David, and 
especially by Thomas Bordenave, who published an important work on 
this subject, collecting a great number of clinical cases of great interest. 
Speaking of the Cowper-Drake operation, he expresses the opinion that 
the tooth to be extracted is not the same in all cases, for if some one of 
the teeth situated below the maxillary sinus should either show signs of 
decay or be the seat of persistent pain, the choice should fall upon that 
one. If, however, these teeth are all apparently sound, the one should be 
chosen that, under percussion, is most sensible to pain. In those cases 
in which the choice is altogether free, Bordenave prefers the extraction of 
the first large molar, for the double reason that it is generally situated in 
correspondence to the central part of the cavity, and that it is separated 
from the antrum by a very thin osseous lamina. In certain cases, the 
maxillary sinus is divided, by body lamellae, into various cavities, and 
then, as one easily understands, it may be necessary to extract more than 
one tooth for the evacuation of the pathological contents. When the 
teeth situated below the antrum have fallen out, or have been extracted 

* Die Zahnheilkunde, Krlangen, 1851, p. 398. 


some time, and their alveoli are in consequence obliterated, it will be 
better to have recourse to Lamorier's method. This method may besides 
be useful, according to Bordenave, either when all the teeth are sound and 
it would consequently be a pity to sacrifice any of them, or in special cases 
(such as large polypi of Highmore's antrum, extraneous bodies, etc.) 
in which the Cowper-Drake operation would not afford sufficient space. 

L. B. Lentin, a German, in 1756, published a pamphlet^ in which he 
recommended electricity as a means of cure for toothache. Other writers 
recommended the use of the magnet, which means of cure had already 
been advised for various affections by Patacelus. During the latter half 
of the seventeenth century, Talbot, J. J. Weckes, and P. Borelli related 
several cures of headache and toothache by the use of the magnet. In 
the eighteenth century F. W. Klaerich, a medical man in Gottingen, 
wrote that he had used the magnet advantageously in not less than 130 
cases of toothache.' We find it recommended later by others, Brunner, 
and particularly J. G. Teske, who, in 1765, wrote a pamphlet entitled 
New experiments for the curing of toothache by means of magnetic 

He considers the use of the magnet as the most efficacious of all remedies 
against toothache, and believes its action to be similar to that of electricity. 

In the following year, however, the belief in the new means of cure 
was sensibly shaken by F. E. Glaubrecht, who declared that although 
the magnet calms or causes the cessation of the pain at first, it returns 
constantly and with much greater violence.* The curing efficacy of the 
magnet in cases of toothache was highly vaunted in France by Condamine.* 

Pasch attributes the effects of the magnet to the chill produced in the 
parts to which it is applied; in proof of this he adduces the fact that if the 
magnet becomes heated by being kept some time in the hand, it loses its 
efficacy altogether, whilst on the other side one may obtain the very 
same beneficial results with a simple steel spatula, just on account of the 
action of the cold; finally, he adds that the chill produced by the magnet 
on the affected part explains very well not only the good, but also the 
bad effects which it produces in many cases, such as increase of the pain, 
inflammation, tumefaction, and even at times spasmodic contractions.* 
Thenceforth the enthusiasm for the magnetic cure diminished gradually, 
all the more so inasmuch as that shortly after the celebrated English 

* Von der Wirkung der elektrischen Erschiitterung im Zahnweh. 
^ Geist-Jacobi, p. 165. 

' Neue Versuche zu Curirung der Zahnschmerzen vermittelst eines magnetischen Stahles, 
Konigsberg, 1765. 

* F. E. Glaubrecht, De odontalgia, Argentorati, 1766. 

* Journal de Medecine, 1767, p. 265. 

* Jos. G. Pasch, Abhundlung aus der Wandarznei von den Zahnen, etc., Wien, 1767. 


dentist Thomas Berdmore ridiculed it by placing it in the same class as 
charms, exorcisms, and other foolish and superstitious means of cure.* 

Adam Anton Brunner. One of the most distinguished German 
dentists in the second half of the eighteenth century was Adam Anton 
Brunner. His two principal works are the Introduction to the science 
necessary for a dentisty^ and the Treatise on the eruption of the milk teeth.^ 

This author falls into various errors with regard to deciduous teeth. 
According to him they are twenty-four in number, and without roots; 
but these may develop in those milk teeth which in exceptional cases 
remain in their places after the period in which they generally are shed. 

A milk tooth, says Brunner, ought never to be extracted unless there 
be manifest signs of the presence of the corresponding permanent tooth, 
or when it is painful and decayed. Badly grown teeth can often be put 
in order solely by the pressure of the fingers frequently repeated, but when 
this is not sufficient, one must have recourse to waxed threads or to special 

In applying a pivot tooth, he screws the pivot to the artificial crown 
and perforates the root canal only just sufficiently to admit the other 
extremity, which he drives in by little strokes of a hammer upon the 
crown, without its being necessary to use cement. We learn from this 
author that in his time there were turners and other craftsmen who 
occupied themselves with dental prosthesis.* 

Brunner prefers gold for fillings to any other substance whatever. 

J. G. Pasch, whose name we have already mentioned, relates the 
case of a young maidservant becoming suddenly affected with deafness, 
and who recovered her hearing completely on the eruption of one of her 
wisdom teeth. From a passage of this author's we learn that at that 
time many had recourse to the crushing of the infraorbital nerve as a 
cure for certain cases of toothache. He, however, decidedly rejects 
such a remedy, as it proves for the most part ineffectual and may, besides, 
produce very serious consequences. This author carried out many 
experiments as to the effects of acids on the teeth.* 

C. A. Grabner* recommends not deceiving children by extracting 
their teeth unexpectedly, but rather to persuade them of the necessity of 
the operation; for by deceiving them one loses their confidence, and in 
many cases inspires them with an invincible aversion to the dentist. 

This author invented a so-called "calendar of dentition," for the 

* Th. Berdmore, A treatise on the disorders and deformities of the teeth and gums, London, 

* Einleitung zur nothigen Wissenschaft eines Zahnarztes, Wien, 1766. 
' Abhandlung von der Hervorbrechlung der Milchzahne, Wien, 1771. 

* J. Linderer, vol. ii, p. 431. * Geist-Jacobi, p. 166. 
' Gedanken iiber das Hervorkommen und Wechseln der Zahne, 1768. 


purpose of showing at a glance the period of eruption of each of the 
deciduous and permanent teeth, and as well for noting down the time 
at which the various teeth are changed, so as to avoid every possible 
error in this respect. This calendar consists of a figure or diagram 
representing the two dental arches, with transversal lines that separate 
the different teeth one from the other, the relative indications being also 

The observations of this most sensible and conscientious dentist with 
regard to the extraction of teeth are worthy of note: "The haphazard 
pulling out of a tooth is an easy enough thing; the only requisites for doing 
this are impudence and the audacity natural to the half-starved charlatan. 
But to carry out the extraction of a tooth in such a manner that, whatever 
be the circumstances of the case, no disgrace may accrue to the operator 
or damage to the patient, requires serious knowledge, ability, and pru- 

RuEFF relates the case of a man, aged forty years, who, having made 
use of fumigations of henbane seeds to relieve himself of violent tooth- 
ache, obtained the desired end, but at the same time lost his virile power* 
He, however, reacquired his force by the care of the author.^ 

Thomas Berdmore was the dentist of George III of England, and one 
of the first and most eminent representatives of the dental art in that 
country. Before him, no one had had the appointment of dentist to the 
royal family. In the year 1768 he published an excellent work on den- 
tistry,' that was translated into various languages and went through many 
editions; the last of these appeared in Baltimore in the year 1844, that is, 
seventy-six years after the first English edition — a splendid proof of the 
worth and fame of this work. 

Berdmore contributed to the progress of dentistry in England not only 
by his writings, but also by imparting theoretical and practical instruction 
to many medical students desirous of practising dental art as a specialty.' 
One of these was Robert Wooffendale, who went to America in the 
year 1766, and was the first dentist whose name is there recorded. 

Berdmore considers as the principal advantage of the application of 
single artificial teeth the support they afford to the neighboring ones. 
Although in no way an impassioned partisan of dental grafting, like his 
contemporary, the celebrated surgeon Hunter, he, nevertheless, sometimes 
had recourse to replantation, recognizing the advantages to be derived 
from this operation, provided it be ably and opportunely carried out; 
but he was decidedly averse to transplantation. Before definitely 
inserting a gold filling, Berdmore considers it a good practice to try the 

* Cara belli, p. 91. 

' A treatise on the disorders and deformities of the teeth and gums, London, 1768. 

' See The Rise, Fall, and Revival of Dental Prosthesis, by B. J. Cigrand, p. 148. 


tolerance of the tooth with a temporary filHng of cement or some other 
like substance. His experiments as to the action of acids on the teeth 
are most interesting. He found that nitric acid destroys the enamel in 
a quarter of an hour; muriatic acid acts almost as rapidly, but with the 
difference that it also alters the color of the interior parts; sulphuric acid 
renders the teeth very white, and, even if used for three or four days, 
only destroys a small portion of the dental substance, but by reason of its 
action the enamel becomes rough and can be easily scraped away with 
a knife. Remarkable experiments on this subject were also made later 
by Kemme.^ 

Pierre Auzebi, a dentist at Lyons, published a treatise on odontology 
in 1 77 1, which is only remarkable for certain strange ideas that he therein 
exposes, the entire book being in complete contradiction with the great 
progress already realized, at that period, in dental science. Auzebi 
likens the human body to a hydraulic machine, formed by the union of 
solid and liquid parts. For him the bones are merely folded membranes 
and the teeth are hones composed of small membranes. The author declares 
that he is unable to admit the theory of germs in the genesis of the 
teeth because "these germs, being all in identical conditions as to heat 
and moisture, ought all to develop at the same time like the grains of 
corn in a field." Rather than having their origin from special germs, 
the teeth, he says, are derived from lymph, this being, according to Auzebi, 
the fundamental substance from which all the hard parts of the body are 
generated. A drop of lymph gathered at the bottom of the alveolus 
hardens and constitutes the first beginning in the formation of the teeth. 
Beneath this other lymph is gradually collected, which pushes upward 
and the part of the tooth already formed, surrounds the dental vessels, 
and thus becomes the root of the tooth. To facilitate dentition he recom- 
mends, among other things, rubbing the gums with hard, rough, and 
angular bodies. He also maintains, as does Brunner, that the milk teeth 
have no roots, contradicting, in this respect, the opinion of Fauchard, of 
Bunon, of Bourdet, who decidedly affirm that the deciduous teeth are 
furnished with roots, precisely the same as the permanent ones. Accord- 
ing to him, when it so happens that the milk teeth have roots, they are not 
shed. To calm toothache, the author recommended a sedative elixir, the 
aspirating of a few drops of which sufficed to obtain the desired effect.' 

John Aitkin, in 1771, perfected the English key, so as to render the 
extraction of the teeth easier and to avoid the danger of fracturing the 
alveolus or the tooth itself, and of injuring the gums.' 

* Cara belli, p. 91. 

' Carabelli, p. 93; Lemerle, Notice sur Thistoire de Tart dentaire, p. 117. 

' J. Aitkin, Essays on several important subjects in surgery, London, 1771. 


Frere Come, a celebrated French surgeon, also contributed to the 
perfecting of this instrument.^ 

In 1771-72, Fr. L. Weyland and Henkel recorded some very impor- 
tant cases of diseases of Highmore's antrum.' 

W. Bromfield, in a collection of surgical observations and cases pub- 
lished in London in the year 1773, also speaks of affections of the maxillary 
sinus. He says that he has had opportunity of persuading himself that 
the purulent gatherings of this cavity not unfrequently discharge spon- 
taneously during the night, finding their exit through the natural orifice 
of the antrum, when the body is in the horizontal position.' 

John Hunter, the celebrated surgeon, must be named among the 
most illustrious champions of odontology in England. He was born 
February 13, 1728. His first instructor in medical studies was his brother, 
William Hunter, a scientist of great merit, whose school of anatomy in 
London was attended by numerous students from all parts of the British 
Kingdom. Under so excellent a guide John Hunter made rapid progress, 
and in less than twenty years became the most famous physiologist and 
professor of surgery of that day. He was surgeon-general to the English 

His Natural History of the Human Teeth (London, 1771) and his 
Practical Treatise on the Diseases of the Teeth (London, 1 778) initiated 
in England a new epoch for the dental art, which, abandoning its blind 
empiricism, began to take its stand on the basis of rigorous scientific 

But although Hunter's merits were great with respect to the scientific 
development of odontology, we must remember that he was a general 
surgeon, and not a dentist, and that precisely for this reason he had not, 
neither could he have, other than a restricted personal experience relative 
to the treatment of dental diseases. This explains why the anatomical 
and physiological part of Hunter's works on the teeth is so far superior 
to the part concerning practical treatment. 

Indeed, in the field of practice, this author often falls into grave con- 
tradictions, and is frequently hesitating and uncertain on important points 
of dental therapeutics. 

Hunter gives a very long and detailed description of all the parts con- 
stituting the oral cavity and the masticatory apparatus. He sought to 
establish a scientific nomenclature for the teeth, and in fact the denomina- 
tions of cuspidati for the canine teeth and of bicuspids or bicuspidati 
for the small molars originated with him. Hunter says that the enamel 
of the teeth is a fibrous structure, and that its fibers depart from the body 

* Sprengel, vol. ii, p. 348. * Sprengel, p. 350. 

' Bromfield, Chirurgical observations and cases, London, 1773. 


of the tooth like rays. He believes it to be entirely inorganic, as it is 
absolutely impossible to convert it into animal mucus. The tooth is 
constituted for the most part by a long mass (it is thus he calls the dentine), 
which is, however, much harder and denser than any other bone. This 
part of the tooth is formed of concentric lamellae, and is vascular, as is 
proved by the exostosis of the roots and the adhesions that exist at times 
between the roots and the alveoli. Hunter gives a good description of 
the pulp cavity and of the pulp itself. He studied odontogeny with great 
care, as is demonstrated by his special researches on this point. He 
admits the existence of distinct germs for the enamel and for the dentine. 
According to him the incisors are formed from three points of ossification, 
the canines from one, and the molars from three or four. The tooth after 
its eruption is an extraneous body " with respect to a circulation through 
its substance, but they have most certainly a living principle by which 
means they make part of the body, and are capable of uniting with any 
part of a living body." The milk teeth, says Hunter, are not shed by a 
mechanical action of the second teeth, but by an organizing law of Nature. 
The physiology of the masticatory apparatus is treated by Hunter with 
great accuracy and most extensively. This author combats, by many 
arguments, the opinion that the teeth grow continually; he explains the 
apparent lengthening of those teeth whose antagonists are wanting, by the 
tendency of the alveoli to fill up, which, however, is not possible in normal 
conditions, because of the constant pressure exercised upon the teeth by 
their antagonists. 

Caries, says Hunter, is a disease of altogether obscure origin; it is not 
owing to external irritation or to chemical processes, and seems to be a 
morbid form altogether peculiar to the teeth. Only in very rare cases 
does it attack the roots of the teeth. It rarely appears after fifty years of 
age. Hunter does not admit that this disease may be communicated by 
one tooth to another. As to its treatment, the caries, if superficial, may 
be completely removed by filing the decayed part of the tooth before the 
disease penetrates to the cavity, and its spreading will thus be arrested 
for a time at least. In cases where the caries penetrates to some depth, 
without, however, the destruction of the crown of the tooth being so 
extensive as to render it useless. Hunter believed the best mode of treat- 
ment to be extraction and replanting of the tooth after having subjected 
it to boiling in order to cleanse it perfectly and to destroy its vitality entirely, 
this being, according to him, the mode of preventing the further destruction 
of the tooth, which once dead can no longer be the seat of any disease. 
If, instead, one wishes to have recourse to cauterization of the nerve, it 
is necessary to reach as far as the apex of the root; which, however, is 
not always possible. This is a very important point, for no one before 
Hunter had yet affirmed the necessity of entirely destroying the diseased 


pulp as an indispensable condition of the success of the filling to be later 
carried out in order to conserve the tooth. 

Hunter is extremely concise when speaking of the filling of teeth; 
considering the great importance of this argument, his conciseness 
can only depend on his having had no personal experience in the matter. 
He considers lead preferable for fillings. 

The frequent occurrence of erosion of the teeth, whether of the cuneiform 
variety or of other kinds, did not escape the attention of this acute observer, 
but he was not able to give any explanation of it. 

In cases of empyema of Highmore's antrum. Hunter advises the 
opening of the cavity through the alveolus of the first or second large 

Periodontitis is classified by the author among the diseases of the 
alveolar process. He occupies himself with this affection at great length, 
seeking to explain the mode in which it is produced. He distinguishes 
two forms of the disease, according to whether or not there be exit of 
pus from the alveolus. The alveolar process is, in his opinion, the 
principal seat of the disease, to which, as a complication, is added the retrac- 
tion of the gums. For the diseased alveolus the tooth becomes, in a 
certain manner, an extraneous body, of which it tends to rid itself. The 
alveolar margins undergo absorption; the bottom of the alveolus tends to 
fill up, analogously to what occurs after extraction, and the falling out of 
the tooth ensues as a natural consequence of this process. An altogether 
similar process, producing the falling out of the teeth, is the normal 
consequence of senility. 

The author considers that the malady in question has as its point of 
departure an irritation caused by a tooth; and as almost a proof of this 
he relates a case in which the extraction of the affected tooth, an upper 
incisor which became too long, and the transplantation of another tooth 
caused the cessation of the morbid process and the perfect consolida- 
tion of the transplanted tooth. However, Hunter does not draw from 
this isolated case the conclusion that transplantation may be elevated 
to a method of cure for this malady. Indeed, he says that, so far as is 
known to him, there is no means of prevention or of cure for it. His 
treatment, therefore, is merely directed to the curing, in so far as is 
possible, the phlogistic symptoms, by scarifications of the gum and by the 
use of astringent remedies. He does not exclude the possibility of a com- 
plete recovery, but the mode in which this obtains seems to him as obscure 
as is the nature of the disease itself. 

In speaking of the correction of dental irregularities, Hunter advises 
not to extract the milk teeth unless this be an absolute necessity. He 
says, besides, that it is useless to extract any tooth whatever, unless one 
endeavors at the same time to force the irregular tooth or teeth into their 


normal position by exercising the requisite pressure upon them. In young 
subjects the regulating of crooked teeth is an easy matter, because of the 
softness of the maxillary bone. However, it should not be undertaken 
before all the bicuspids have come through. To correct protrusion of the 
upper jaw, the author recommends the extraction of a bicuspid on each 
side. To regulate the incisors it is sometimes necessary to make them 
rotate on their axis with the forceps. In certain cases of protrusion of 
the lower jaw one may have recourse with advantage to the inclined plane. 

As a general rule, it is useless to lay bare a tooth with the lancet 
before extracting it, although in certain cases this may be advantageous 
in order to render its extraction easier and less painful. 

Hunter was a strenuous partisan of replantation and transplantation 
of the teeth; he made various experiments on animals, and treated this 
important argument with particular fulness and much better than had 
been done up to then by others. 

In cases of difficult dentition he considered incision of the gums most 
useful and, if necessary, to be had recourse to several times. 

Foucou, the French dentist, in 1774, made known a compressor in- 
vented by him for arresting hemorrhage ensuing on the extraction of 
teeth. This instrument, which could be used for either jaw, exercised its 
pressure not only in a vertical direction, but also laterally, and did not give 
much inconvenience to the patient. Carabelli, who wrote seventy years 
later, speaks with praise of Foucou's compressor, which he considers the 
best instrument of its kind. 

CouRTOis, in his book published in 1775,* says that the enamel of the 
teeth only reaches its perfection of development at twenty to twenty-two 
years of age, and begins thenceforward to wear away gradually. In 
speaking of the enamel, he advises avoiding the use of the file as much 
as possible. This author's book is interesting for the many important 
clinical cases it contains. 

WiLLiCH, in 1778, related a most curious case relating to a woman, 
aged forty years, who had never had her menstrual function, but had, 
nevertheless, given birth to two children; the extraction of a tooth was 
followed by an alveolar hemorrhage that lasted an hour; thenceforward, 
this hemorrhage recurred regularly each month, for the space of eight 

BlXKiNG, in 1782, published a Complete Guide to the Extraction of the 
Teethy^ wherein he minutely describes all the instruments, their use, the 
position of the operator and of the patient, indicating at the same time 
the instruments best adapted for the extraction of each tooth. He declares 

' Le dentiste observateur, Paris, 1775. 

' Vollstandige Anweisung zum Zahnausziehen, Stendal, 1782. 


himself averse to the practice of subluxation as a means of cure for tooth- 
ache, a method which, first recommended by the Arab physician Avicenna, 
and later, in the sixteenth century, by Peter Foreest, had fallen into 
oblivion for a long time, and was again brought into credit by two cele- 
brated French dentists, Mouton and Bourdet, the latter of whom relates 
having had recourse to it successfully in not less than six hundred 

Notwithstanding the high authority of this illustrious dentist. Bucking 
does not consider this method of cure advisable, adducing, however, 
in support of his opinion, arguments of no great value, viz., that teeth 
after subluxation continue painful for a certain time, and that they always 
remain in an oblique position. The method in question, which has the 
effect of breaking the dental nerve, is, in our opinion, practically equivalent 
to a replantation, or is, in point of fact, a replantation, when the luxation 
of the tooth is complete. The arguments that Bucking brings forward 
against it are futile; the first objection, for the most part, does not subsist, 
and, in any case, the persistence of pain for a short time would be of small 
importance compared with the great advantage of preserving the tooth; as 
to the second, it is to be understood of itself that subluxation performed 
by means of the pelican (the instrument then used for the operation) 
would cause the tooth to assume an oblique position; but even supposing 
it did not straighten up of itself, there could not have been any difficulty 
for the good dentists of that period in forcing the tooth again into normal 
position and in maintaining it there. The weak side of the operation 
consisted rather in the fact of its being probably carried out without due 
consideration of the dangers resulting from the possible alterations of the 
dental pulp. 

At the time of which we are writing many believed that the enamel of 
the teeth could be regenerated altogether or in part, and that, therefore, 
it was of no great consequence that it should be worn away by the use of 
the file or of abrasive dentifrice powders. Thus, for example, the renowned 
surgeon Theden expressly recommended such powders, as the best adapted 
for cleaning the teeth and for freeing them from tartar.^ 

Van Wy,^ the Dutch surgeon, in 1784, related two cases of regeneration 
of the maxillary bones; other cases of the same kind were related some 
years later by Percy and Boulet.' 

Chopart and Desault recommended, in cases of difficult dentition, 
the excision of the gum in correspondence with the teeth that are to come 
out, rather than simple incisions.* 

* Theden, Neue Bemerkungen und Erfahrungen, Berlin, 1782, part second, p. 254. 

' J. van Wy, Heelkundige Mengel stoffen, Amsterdam, 1784. 

' Journal de Medecine, 1791, tomes 86, 87. * Sprengel, p. 356 to 357. 


Antonio Campani, of Florence, published in 1786 a treatise on den- 
tistry,' very elegantly printed, and illustrated with thirty-six plates very 

Pelican for extraciing 

neatly carried out. This book, however, contains nothing of real impor- 
tance for the development of dentistry. 

' Odontoiogia, ossia Trattato sopra i Demi. 


Benjamin Bell, the English surgeon, a contemporary of Hunter, 
also devoted much attention to diseases of the teeth, and, if it may be 
argued from the clear and precise manner in which he expresses his 
opinions on various questions relating to dental pathology and therapy, 
it would seem that he had much greater experience in this Beld than the 
celebrated Hunter. 

Fig. 97 

;th (Campani). 

With regard to incision of the gums, in cases of difficult dentition, this 
author contradicts certain assertions of the German surgeon Isenflamm 
(1782), who argued that when the tooth is already to be perceived through 
the gum, the incisions are altogether useless, while if the tooth be still at 
some depth, the gingival incision will soon close again, so that the cicatrix 


will render the eruption of the tooth still more difficult. Bell admits, too, 
that lancing the gum is altogether superfluous when the tooth has pierced 
the tissue, all the more so that the accidents provoked by the erup- 
tion are then generally already passed and gone, but the operation ought, 
in his opinion, to take place much earlier; and should the wound close 
again before the tooth has erupted, the gum must be lanced a second time. 

Campani's forceps; The first for molar t«eth when loose or after having been shaken 
with the pelican; the second for deciduous teeth. 

Bell contradicts the opinion of Jourdain and Hunter that the morbid 
gatherings of Highmore's antrum are generally consequent upon the closing 
of the normal opening of the cavity in the middle meatus. In many 
cases of disease of the maxillary sinus this orifice remains open, the 
liquid therein collected discharging itself not unfrequently through it, 
in certain positions of the body. Instead of penetrating into the antrum 



through the nasal orifice, as Jourdain would have it, Bell advises opening 
the cavity by Lamorier's, or, better still, by Drake's method. Except in 
special cases, the first or second molar ought to be extracted, but prefer- 
ably the second. After trepanning the alveolus and emptying the cavity, 

Fig. 99 

Two key instruments with changeable hooks (Campani). 

the opening should be closed with a conically shaped peg to prevent 
its slipping into the cavity. From time to time the liquid that tends to 
reaccumulate should be allowed exit, and detersive injections should be 
made, preferably of lime water. 


Looseness of the teeth, which in old age may Be considered a norma] 
condition, is always a disease when it occurs in youth. In certain cases 
its cause is unknown, in others it depends on an affection of the gums, 
either of a scorbutic nature or consequent on an accumulation of tartar. 

r especially destined to extract loose bicuspid teeth. The screw in the 
interior of the instrument allowed the hook to be brought to just the right point in each 
case (Campani). 

According to Bell, dental caries is generally owing to a bad condition 
of the humors of the entire body and to a peculiar morbid disposition, 


rather than to external causes acting locally, although these latter may 
contribute, together with the general causes, to the producing of the 


IS of post-extractive hemorrhage; the 

This author was decidedly averse to the use of the file. For stopping 
carious cavities he advises the use of mastic, gum lac, or wax, if the cavity 
is large and funnel-shaped; this stopping, however, requires to be renewed 
frequently. But when the cavity, wider at the bottom, narrows toward 


-••W&A/ <^«(u act i*-*ua**t^ at/^tr 
7im/. €Jf£MANr^4H*if ^i' t/0tMa4^- 


the surface, one ought to use gold or, still better, tin-foil. The pulp 
ought always to be destroyed previously by cauterization. 

Bell advises great caution in carrying out transplantation, it having been 
proved by many examples that contagious maladies of a serious nature 
may easily be communicated in this way from one individual to another.* 

In the case of a young woman who had an upper incisor transplanted, 
Watson observed undoubted symptoms of syphilitic infection with super- 
vening accidents of exceptional gravity, which in spite of careful treatment 
ended in death. ^ 

Hunter also relates having observed, in seven cases of transplanta- 
tion, very serious accidents which, however, he did not believe to be 
owing to syphilis, ialthough bearing a certain symptomatic resemblance 
to it. Contrariwise, the well-known German surgeon Richter not only 
admitted the possibility of transmitting syphilis through a transplanted 
tooth, but even that the transplantation of an altogether healthy tooth 
from the mouth of a person undoubtedly free from syphilis might be 
followed by serious accidents of a syphilitic nature, and this because the 
possible existence of a latent syphilis in the person to whose mouth the 
tooth was transplanted cannot be excluded; in which case the abnormal 
stimulus exercised by the transplanted tooth might very well give rise 
to syphilitic manifestations. Therefore, the fact that the person who 
furnished the tooth was and continued to be in a state of perfect health 
(as precisely in the case cited by Watson) would not be sufficient proof 
that the accidents ensuing on the transplantation might not be of a 
syphilitic nature. 

Lettson also observed, in certain cases of transplantation, accidents 
of more or less gravity which he held to be due to syphilis, calling, 
however, to mind a case cited by Kuhn, of Philadelphia, where the 
possibility of syphilis was not to be thought of, as the morbid symptoms 
disappeared entirely, without any treatment, as soon as the transplanted 
tooth was removed.^ 

August G. Richter, the above-named German surgeon, in those 
portions of his work dedicated to dental affections and diseases of High- 
more's antrum, treated these subjects with admirable clearness and order, 
without contributing, however, anything original to the development of 
dental surgery.^ 

Nicholas Dubois de Chemant, in 1788, of whom we shall later have 
occasion to speak again, published in Paris his first pamphlet on mineral 

' Benjamin Bell, System of Surgery, 1783 to 1787, vol. iii. 

' Medical Transactions of the College of Physicians of London, 1783, vol. iii, p. 325. 
^ Memoirs of the London Medical Society, 1787, vol. i. 

* August Gottlieb Richter, Anfangsgriinde der Wundarzneikunst, vol. ii (1787) and vol. 


teeth, entitled Sur les avantages des nouvelles dentSy et rateliers artificielsy 
in corrupt iblesy sans odeur. 

Jean Jacques Joseph Serre (1759 to 1830). Among the dentists of 
he end of the eighteenth century and the beginning of the nineteenth, 
a special mention is due to Jean Jacques Joseph Serre. He was born at 
Mons, in Belgium, but his remarkable practical and scientific activity 
was chiefly called into exercise in Vienna and in Berlin. He published 
several works, the most important of which is a practical treatise on 
dental operations.^ 

Among his minor works, one edited in Vienna, in 1788, treats of tooth- 
ache during pregnancy; another, printed in Leipsic in 1791, treats most 
extensively of diseases of the gums; a third speaks of the mode of main- 
taining the teeth and gums in good condition. This little book of dental 
hygiene, like the rest of Serre's books, met with great favor, and went 
through two editions in a brief space of time (Berlin, 1809 to 1812). 

The works of this author show great study, very wide practice, and an 
admirable spirit of observation and research. They had the merit of 
greatly contributing to raise the level of dental culture in Germany, and 
one finds in them a pretty nearly complete account of the dentistry of 
that period. Apart from this, they possess a special interest because of 
the vast number of dates and important historical facts therein contained. 

As it would be useless here to enter into a minute analysis of the contents 
of these books, we will limit ourselves to mentioning a few ideas of which 
Serre was a strenuous supporter. 

He combats an old prejudice that had recently been reinforced by the 
authority of Jourdain, that is, that it does harm to extract a tooth when 
the soft parts around it are inflamed and swollen. He likewise combats 
the prejudice, also of very ancient date, that teeth ought not to be extracted 
during pregnancy. Only, he considers it as well to avoid the cauterization 
of the dental pulp in cases of gestation. In extracting teeth, the forceps 
ought only to be used after the tooth has been luxated by means of the 
pelican. Serre highly approves of this instrument, although he recog- 
nizes it to be a dangerous one in the hands of those who do not know 
how to make a proper use of it. This author invented or perfected various 
extracting instruments, among which a conical screw for extraction of 
roots hollowed out by caries deserves particular mention, and which, 
under a somewhat modified form, is still in use. 

One of the most interesting chapters of Serre's great work is the one 
in which he treats of affections of Highmore's cavity.' He speaks at 
length of the anatomy of the maxillary sinus, of its relation to the teeth 

^ Praktische Darsteiiing aller Operationen der Zahnarzneikunst, Berlin, 1803 and 1804. 
' Chapter xlii. 


situated below it, of the various modes in which the diseases of the antrum 
are produced, of their symptoms and treatment. He passes in review 
the various operative methods, and finds that in general the Cowper- 
Drake is the one to be preferred to all the others. He says that to open 
the sinus the simple extraction of a molar suffices in the greater number 
of cases, the trepanning of the alveolus not being generally necessary. 

J. Arneman, in 1766, published at Gottingen a synopsis of surgical 
instruments^ that deserves mention in so far that the dental instruments of 
that time as well as those of earlier periods are therein taken into account 
with sufficient exactness. 

A. F. Hecker attributed the accidents of difficult dentition to a special 
alteration of the saliva caused by the irritation deriving from the erupting 
teeth. In these cases the saliva is supposed by him to acquire a high 
degree of acridness and to become almost similar to the poison of rabies. 
Departing from this theory, the author declares it to be necessary to miti- 
gate the irritation produced on the gums and other parts of the mouth 
by the altered condition of the saliva, as well as to modify the quality of 
the saliva itself and to promote the elimination of the same from the body 
by emetics and aperients. According to him, liquid carbonate of potash 
administered in drops, together with syrup of poppy heads, manna, etc., 
is a most useful remedy, having specially for its effect to diminish the 
acridness of the saliva. 

Besides this remedy, the author extols the use of blisters behind the 
ears, as also of tepid baths, which calm pain and spasms, favor the excre- 
tions, and procure repose and sleep. He rejects the incision of the 
gums as altogether useless, and is most opposed to the use of opium, 
which he states renders children liable to apoplexy. 

And here we will mention, rather by way of curiosity than for any 
real historical interest which they possess, two pamphlets on odontitisy 
published respectively in 1791 and 1794 by Ploucquet and Kappis, who 
maintained that not only the dental pulp, but all the parts that form the 
tooth are susceptible of inflammation.^ In Kappis* pamphlet we find the 
following ideas developed, upon which we do not think necessary to com- 
ment. The inflammatory process consists essentially in the increased flow 
of humors to a given part and in a more or less intense reaction of the 
vital force. Both of these things may take place in the teeth. These are 
liable to swell, that is, to undergo an increase of all their dimensions, in 
proof of which assertion the author relates the case of an individual, 
who when attacked by a violent toothache had found the spaces between 
his teeth so narrowed that it was no longer possible to make use of his 

* Uebersicht der Chirurgischen Instrumente. 

' Ploucquet, Primac linex odontitidis, sive inflammationis ipsorum dentium, Tubingar, 
1 791; Kappis, Primac lineac odontitidis, etc., Tubingae, 1794. 


usual toothpick, even if he had tried to do so regardless of pain. But 
when the toothache was over, the same toothpick again became semce- 
able as before. He savs that there is no cause for wonder that in odon- 
this no redness of the teeth is to be perceived, for in other inflammations 
as well, redness is wanting, and, moreover, it exists in the interior mem- 
brane of the tooth. As in other inflammations, so also in odontitis, the 
usual issue is resolution. Dental fistulae may derive from internal sup- 
puration. The impurities deposited on the teeth are by him supposed 
to be owing to an increase of their secretion ! According to the author, 
caries, the breaking down of teeth apparently healthy, as well as their fall- 
ing out, is generally caused by an inflammation of these organs, that is, 
by odontitis, an affection that, he says, may be of ver\' varied kind, the 
principal forms being the rheumatic, arthritic, sympathetic, and gastric. 

Ranieri Gerbi.^ In a book by this author we find recommended a 
very singular cure for toothache, even of the most violent nature. It 
is in no way scientific, and is besides not particularly pleasant, notwith- 
standing that the author, professor at the University of Pisa, was a 
scientist of merit, enjoying special esteem as a mathematician and 
cultivator of natural sciences. 

Under the name of curculio anti-odontalgicus he describes an insect 
living habitually inside the flowers of the carduus spinosissimusj that 
could be used with great advantage against toothache, in the following 
manner: One crushes fourteen or fifteen larvae of the insect beti^-een the 
thumb and forefinger, and then rubs the two fingers together until the 
matter remaining upon them is entirely absorbed. Instead of the lar>'ae 
(which, as is known, represent the first stage of insect life) one may also 
use the fully developed insects. One then applies the two fingers that 
have crushed the insects or their larvae upon the decayed and aching 
tooth. If the pain is of a nature to be cured by this means, it diminishes 
almost instantaneously, and ceases altogether in a few minutes. It is 
said that the fingers preserve their healing power for a great length of 
time, even a whole year, and in proof of these assertions Ranieri Gerbi 
speaks of no less than six hundred cures performed! Other insects 
besides the curculio antt-odontalgicusy used in the same manner, are said 
to possess the same curative properties, among them the curculio jaceay 
carahus chrysocephaluSy and the curculio Bacchus^ which last, says Gerbi, 
has long been used for this purpose by the peasants of Tuscany. The 
author also says that some German doctors and naturalists experimented 
with success with several insects indigenous to Germany as remedies 
against toothache. These insects, also mentioned in a work published in 
Bayreuth in 1796, author unknown, are:^ the cocci nella septempunctatay 

' Storia naturale di un nuovo insetto, Firenze, 1794. ' Der anfrichtige Lahnarzt. 


the coccinella hi punctata^ the carabus ferrugineuSy the chrysomela sanguino- 
lentQy the chrysomela populiy the cantharis or Spanish fly, and others. 
Later on, Hirsch also extolled the healing power of another insect, the 
cynips rosarum. With regard to the mode of application, Gerbi says 
that instead of crushing and rubbing these insects or their larvae between 
the fingers, one can use a piece of wash leather in a similar manner. 

It is to be observed, however, that the insects that are found generally 
in the ripe wild teasle — or more precisely their larvae — had already been 
used for a long time as a remedy against toothache; indeed, we even find 
these means of cure recommended in the natural history of Pliny. In a 
book entitled Histoire J*un voyage aux lies Malouines fatt en 1763 et 
1764, by a certain Dom Pernetty, this author speaks of some remedies 
made known to him by the Superior of the Franciscan friars of Monte- 
video; and among others one finds the following: "One draws out the 
worm that is generally found in the head of the fuller's teasle when this is 
ripe. One rolls this worm between the index finger and the thumb, lightly 
pressing it until it dies of languor. The one or the other of the two fingers 
applied on the aching tooth will have the virtue, for a year at least, of 
making the toothache cease. "^ 

Heinrich Callisen, in an excellent treatise on surgery^ published at 
Copenhagen in 1788, writes at sufficient length and with great accuracy 
on dental and maxillary diseases. According to this writer, it rarely 
suffices to trepan one alveolus for the treatment of the morbid collections 
of Highmore's antrum, as the maxillary sinus is very often divided by 
partitions into various cells, so that in order to give exit to the pus 
contained in each of them, it is necessary to extract several teeth and 
trepan their alveoli.' One ought not, therefore, to give the preference to 
this method, unless in the case of the teeth in question being decayed. 
But should they all be in a good state, or should a large opening be 
necessary because of the nature of the disease in the cavity, it will be better 
to follow Lamorier's method, that is, to incise the gum crosswise under 
the malar process and then, after scraping away the periosteum, trepan 
the bone. Further, in the case of the disease in the maxillary sinus 
having given rise to tumefaction, softening of the bone, and fluctuation 
in the palatine region, it is precisely there that the perforation ought to 
be carried out. To prevent the reclosing of the opening before the 
cure is completed, the author advises the use of pledgets, small bougies, 
a piece of prepared sponge, or even a small tube. According to Callisen, 

* Without comment! ' Principia systematis chinirgiz hodiernae. 

^ The anatomical fact alluded to by the author, far from presenting itself very often, 
as he says, is of rare occurrence, and cannot be held in account for establishing a general 
operative rule. 


above fifty years of age, the transplanted teeth do not take root perfectly 
except ill an average of one case in three. For carrying out this operation 
he never made use of teeth extracted from the mouth of a living person, 
but, on the contrary^ he used the teeth of young and healthy subjects 

Upper denture in ivory, ar the eml of the eighteenth century, for a case in which thfti 
last molars and the front teeth were present. {From Guerini's colleaion.) 

who had died a violent death; these were, besides, carefully cleaned 
before transplanting them, and in this way the author believed the trans- 
mission of disease to be nearly impossible.' 

[. E. WicHMANN combated energetically the practice, then preny 
general, of endeavoring to facilitate the eruption of the teeth by 

' Hlrsch. Praktische Berne tk.i net n uherdieZ^hnt iind einice Ktankhciten dcrsclben. 
Jena. 1 70. 


incision of the gums. He considered this practice as one to be absolutely 
reje.cted, supporting his opinion on the consideration that dentition, 
being an altogether physiological process, which, moreover, takes place 
in parts relatively of but little importance, never can give rise of itself 
alone to serious accidents. Besides this, he says, it is very difficult to 
say which tooth precisely is about to erupt and at what point. The 
incisions would, therefore, have to be made by chance, which would often 
render the morbid condition still more serious. 

K. A. Blumenthal endeavored to confute Wichmann's opinions, 
with but little success; for, indeed, the same opinions, expressed later 
by J. H. Sternberg in a more detailed manner and with ampler views 
of the subject, met with ever-increasing approval. Thenceforth, the 
practice of gingival incisions in cases of difficult dentition fell more 
and more into discredit.^ 

Robert Bunon,^ the French dentist, is one of the most illustrious per- 
sonalities to be met with in the history of our profession. He was born 
at the beginning of the eighteenth century, and devoted himself betimes to 
the dental art, gathering instruction therein partly from different dentists 
and partly from the few odontological books he was able to find. In this 
manner he learned pretty much all that was known at that time by dentists 
in general. He then decided to travel, in order to acquire further knowl- 
edge and experience. He practised especially in the north of France and 
in what is now the state of Belgium; at Antwerp, Brussels, Givet, Mau- 
beuge, Cambrai. In his ardent thirst for knowledge, when he happened 
to pass through a town where some dentist of note resided, he never 
neglected to call on him, thus acquiring fresh information and per- 
fecting himself as well in the practical exercise of his profession. At 
the same time, his desire to learn all that was new concerning dental art 
and science was so intense that he had translations made of the medical 
and surgical works of Latin, Italian, German, and English authors. 
However, all this reading, although it enlarged his general knowledge, 
taught him nothing, or almost nothing, about those subjects that interested 
him above all the others. His practical experiences, meanwhile, brought 
a great number of patients to his notice, and, being by nature a very 
acute observer, he was able to establish the existence of many facts up 
to then unknown. At this time he commenced his studies on dental 
erosion, on the development of the teeth, and on the prophylaxis of dental 
maladies, his favorite subject. "I felt," he writes, "that the necessity 
of having recourse day by day to the extraction of teeth resulted from 

* Sprengel, pp. 376, 377. 

' For all that regards Bunon's life and writings we have availed ourselves of the excellent 
historical work of A. Barden, "Un precurseur: Bunon/' a communication presented to the 
Geneva Session of the International Dental Federation (August, 1906). 


deficient knowledge on our part, and I considered this extreme remedy 
as one of the greatest evils to humanity."^ He therefore endeavored 
to extend his own knowledge in every possible way, and as one means of 
doing this he visited hospitals and schools; and, ardent champion as he 
was of conservative dentistry and of prophylaxis, he succeeded in inter- 
esting medical men and surgeons, midwives and schoolmasters, and parish 
priests as well, in the question of the preservation of the teeth. The teeth 
he extracted he kept for the purpose of studying the conformation, the 
lesions, the dental anomalies; sometimes he split them up to examine 
the dental pulp. And he never neglected an opportunity of procuring 
anatomical pieces that appeared interesting to him. 

In 1728 Fauchard's book, Le Chirurgien Dentiste^ appeared. The 
fame of this work reached Belgium, where Bunon then was, and he 
immediately set about trying to get a copy of it. After searching in various 
towns, he finally found one in Givet. He read it with the greatest interest, 
and later, in one of his works, spoke of it in terms of highest praise. It 
would seem, however, that he did not learn much that was new to him by 
reading this book, which proves that he already possessed a vast odonto- 
logical culture and was also profoundly versed in technical dentistry, 
which forms the most important part of Fauchard's book. He was 
somewhat astonished at finding in this celebrated author's work hardly 
anything on the subjects that principally interested him, that is, the ero- 
sion, the development of the teeth, and the prophylaxis of caries. This 
circumstance very clearly reveals the different mental tendencies in these 
two great men, the one, drawn toward the practical side of the profession 
which principally interests him and forms the basis of his work, the other, 
an impassioned searcher into causes, and student of prophylaxis. 

After the perusal of Fauchard's book, Bunon, who had already con- 
ceived the idea of publishing the results of his observations and of his 
own particular studies, felt more than ever the propriety and necessity of 
doing so; and to realize his idea, he established himself toward the year 
1735 at Paris. Two years later, just when the manuscript of his work 
was almost finished, Gerauldy's book appeared. Bunon relates that he 
opened this book in fear and trembling; its title, The art of preserving 
the teethy gave him reason to fear that Gerauldy might have profited by 
some of the ideas and observations he had communicated to various 
persons, to write a book similar to the one that he himself had it in his 
mind to publish.' He was able, fortunately, to convince himself immedi- 
ately that his fears of being forestalled and plagiarized were unfounded. 

Notwithstanding, Bunon was determined not to publish his book until 
the opportune moment and with all possible probability of success. With 

* Experiences et demonstrations, p. 13. ' Ibid., p. 60. 


this object in view, he made up his mind first to obtain the diploma of 
surgeon-dentist. To reach this aim, he was obliged to conform to the 
regulations of the Edict of May y 1699, which then regulated the practis- 
ing of dentistry, and this was as much as to say that he was obliged to enter 
the College of Surgery, to undertake two years' practice with a regularly 
licensed surgeon, to undergo theoretical and practical examinations, and 
to take oath before the Chief Surgeon of the Realm. Once in possession 
of the diploma of surgeon-dentist, he was separated thenceforward from 
the vulgar crowd of charlatans and invested with all the prestige which 
a degree, so rarely acquired at that time, conferred upon its possessor; 
but before facing public opinion he desired to make himself known, 
and, so to say, first to try his ground, by making known some of his newer 
ideas, and see what reception they might meet with from his colleagues 
and the public in general. He, therefore, published, in January, 1741, 
in the newspaper Mercure de France^ a letter on the so-called eye toothy^ 
combating the then widely diffused prejudice that the extraction of an 
upper canine constituted a grave peril to the eye. He demonstrated the 
absurdity of this idea by putting in evidence the anatomical fact that 
the upper canines are innervated by the infra-orbital nerve, which has no 
relation whatever with the visual organ. 

Still better to further his object of making himself a name, he published 
in the same year and in the aforementioned paper his dissertation on the 
teeth of pregnant women.' There he demonstrated the falseness of the 
idea that one ought never to extract teeth during the state of gestation, 
and brought into relief the necessity of treating the dental diseases of 
pregnant women with still more accuracy than those of other persons. 

These publications, bearing as they did the marks of good sense, 
favorably interested the public opinion. The way was therefore prepared, 
and Bunon judging the moment to have come for publishing his work, 
placed it in the hands of a literary man for the necessary corrections of 
style. He also showed his manuscript to several persons of consideration, 
but was grieved to perceive that the new ideas put forward in it were 
skeptically received. He now thought it might be as well to appeal to the 
judgment of a highly competent authority, and fixed on M. de la Peyronie, 
Head Surgeon of the Realm. This gentleman, after reading the work, 
highly praised the author, and Bunon gained permission to publish the 
book under his patronage, on consideration that he should give his word 
to furnish the proof of the many assertions made therein on all kinds of 

^ Lettre sur la pretend ue dent oeillere. 

' Sur un prejuge tres pernicieux, concernant les maux de dents qui surviennent aux femifies 


The goal was now reached, and Bunon, on the strength of such 
illustrious patronage, published his book in March of 1743, under the 
title, Essay on the maladies of the teeth^ wherein are suggested the means 
of obtaining their good conformation from the earliest age^ and of assuring 
their preservation during the whole course of life} 

All the principal journals of the time (^Journal des SavantSy Journal 
de Trevouxy Journal de Verdun^ Mercure de France^ etc.) published 
extracts from the book and eulogized the author, who had even the high 
satisfaction of receiving an honorable mention from the Royal Academy 
of Surgery, in the public sitting held in 1743. 

Bunon, therefore, was now famous, and had, besides, gained wealthy 
clients, as we see from the perusal of his observations, where the best 
names in France are to be met with, put in evidence by him without the 
least thought of professional secrecy. He could now enjoy his well- 
n)erited successes, in accordance with the thought expressed by him in 
qne of his books: "All those who labor for the progress of an art have 
legitimate right to the honor and to all the recompenses to which success 
is entitled."^ 

The study of Bunon 's work proves, in fact, that he had good right to be 
proud of having written it. The mere perusal of it, however, does not 
suffice to enable the reader to judge of its merits, for to do this properly, 
it is necessary to study at the same time his other book, published in 
1746, entitled Experiences and demonstrations made at the Hospital of 
Salpetriere and at St. Come^ before the Royal Academy of Surgery ^ serving 
as continuation and proof to the Essay on the maladies of the teethe The 
essay is, in fact, a small i2mo book of 212 pages, written in a concise 
style, and, strange to say, most concise in the most important points. 

Many facts of great moment are given under the form of rapid indica- 
tions, or of assertions without proof; thus their importance is apt to pass 
completely unobserved by those who do not take the trouble of studying 
this work thoroughly and with the help of the explanations, illustrations, 
and comments contained in the second book we have referred to. 

M. A. Barden, of the ftcole Odontotechnique of Paris, was the first 
to undertake a serious and conscientious study of Bunon's works. By 
so doing he has thrown full light on the author's great merits, and 
brought forward the high scientific importance of his works. 

* Essai sur les maladies des dents, ou Ton propose les moyens de leur procurer une bonne 
conformation des la plus tendre enfance, et d'en assurer la conservation pendant tout le 
cour de la vie. 

^ Experiences et demonstrations, avertissement, p. xix. 

* Experiences et demonstrations faites a THopital de la Salpteriere et a St. Come, en 
presence de TAcademie Royale de Chirurgie, pour servir de suite et de preuves a I'Essai sur 
les maladies des dents. 


One of the important questions studied by Bunon concerns the hygiene 
to be observed in order to obtain the development of a good dentition. On 
this question he rightly establishes the principle that hygiene and dental 
prophylaxis should begin from the period of the formation of the milk 
teeth. He works out this principle with rigorous logic, and finishes 
by tracing the hygiene of the mother during pregnancy, of the woman 
(be she mother or nurse) during the nursing period, and of the nursling 
as well. 

As to the accidents of first dentition, Bunon sets forth a highly scientific 
opinion, fully coinciding with the ideas of modern writers, that is, that 
dentition is not the sole cause, nor even the principal cause, of such 
accidents, but simply a cooperating cause. He made the observation 
that in healthy infants, children of healthy parents and nursed by healthy 
women, the time of teething is gotten over without difficulty, while 
serious accidents occur frequently in weak and sickly children not brought 
up and nourished according to hygienic principles, or born, as not often 
happens, with special hereditary predispositions. 

One of Bunon's merits is that of having attributed to the first teeth all 
the importance they really have, and of having insisted on the necessity 
of attentively curing their maladies. He also drew attention to the 
dangers that may result from the eventual persistence of the first teeth at 
the epoch of the second dentition, or from the persistence of their roots 
after the destruction of the crown by caries. These roots, he says, by 
their contact with the neighboring permanent teeth may infect them, 
and cause them to decay. 

Bunon's researches into the development of the teeth enabled him to 
describe precisely the position that the various teeth of the second denti- 
tion occupy in the jaw with regard to the milk teeth, before these are 

Bunon was, besides, the first author who studied accurately dental hypo- 
plasia, and it is greatly to his honor that his ideas and observations about 
this pathological condition have been accepted and confirmed in substance 
by the greater part of the authors who have come after him, having 
remarkable worth even at the present day. According to him, this con- 
genital defect of the teeth is owing to infantile maladies, such as hereditary 
syphilis, infantile scurvy, malignant fevers, smallpox, or measles; the 
harmful effects of these maladies, however, are limited to the teeth in 
progress of development, and have no influence on those that have already 
come forth. Erosion, as this defect was termed by Bunon, sometimes 
affects the first teeth, but is to be found much more frequently in the 
second or permanent ones. Those most often affected are the first molars, 
and in frequency follow the incisors, the canines, the premolars; the 
second and third molars are the most rarely affected. 


Bunon studied with great accuracy the means of preventing anomalous 
positions of the permanent teeth, owing, according to him, almost always 
to want of space. In certain cases he advises the extraction of the milk 
tooth in order to facilitate the eruption of the permanent one, and, necessity 
urging, he does not hesitate to sacrifice one of the permanent teeth to 
procure the advantage of a normal position of the others. With regard 
to this subject, the following passage is worthy of note, for in it we find 
sketched out the theory of preventive extraction as a means of facilitating 
the eruption of the wisdom tooth : " It is better to have the teeth incom- 
plete as to number than to have the ordinary number badly arranged; 
for the mouth will appear none the less well furnished because of having 
one or two teeth the less; the other teeth will be commodiously distributed, 
and the last molars will find sufficient room when they come forth; thus, 
the disorders which these teeth often occasion will be avoided."^ 

After caries, Bunon considers dental tartar as the most potent enemy 
to the vitality of the teeth. He distinguishes three principal species: 
the black, the lemon or light yellow, and the brownish yellow; however, 
he allows of two other varieties of less frequent occurrence, the red and 
the green tartar. 

At a period when an extraordinary confusion obtained with regard to 
gingivitis, because of the great number of varieties allowed, Bunon strongly 
affirms the unity of this morbid process, and considers tartar as the con- 
stant cause of it, without denying, however, that other causes of various 
kinds may contribute at the same time to produce it. 

In cases of scorbutic stomatitis, Bunon advises, and very rightly, 
the complete removal of tartar from the teeth before having recourse to 
any other local treatment. He also insists on the necessity of attending 
to the teeth and gums, and especially of freeing the former from tartar 
before undertaking the specific treatment of syphilis, considering the good 
state of the teeth and gums as one of the most important prophylactic 
measures against mercurial stomatitis. 

Anyone who takes the trouble of reading Bunon's works attentively 
cannot help admiring his depth of insight, his spirit of observation, his 
exquisite clinical sense, and his ingenuity. As illustrating this last quality 
of his, we may cite two cases of fracture of the lower jaw that he succeeded 
in curing in a short time by the method of binding the teeth, the preceding 
attempts of experienced surgeons having entirely failed. One of these 
cases is particularly interesting. The seat of the fracture corresponded 
with the bicuspids, which, however, had fallen out from the effects of 
trauma ; the neighboring teeth were also loosened. Bunon filled the empty 
space left by the bicuspids with a piece of ivory, provided with two holes; 

* Essay, p. 127. 













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then, by an ingenious crossing of threads passing from the second molar 
on the one side to the second bicuspid on the other, very tightly tied, he 
formed, so to speak, one single block, and succeeded in bringing about 
the consolidation of the shaking teeth and the complete cure of the 
fracture, which was effected in less than a month. 

The unfavorable judgments passed on Bunon by some writers result, 
in a great measure, from the circumstance that one finds quoted in his 
books certain modes of treatment that today appear positively ridiculous. 
But those who, very wrongly and with deplorable levity, consider Bunon 
as nothing more than a vulgar empiric, ought to reflect that even the greatest 
men cannot altogether avoid the influence of the ideas and the prejudices 
of their time. Some tribute they are almost fatally bound to pay to these 
prejudices. It is, therefore, not to be wondered at, if one finds in Bunon's 
works, as well as in those of many other old writers, indications given 
of more or less strange remedies. Thus, as facilitating the eruption of 
teeth, he recommends among other remedies the rubbing of the gums 
with a mixture of honey, fresh butter, hare's brains, and oil of lilies, or 
with the fat of an old cock, dog's milk, and pig's brains. Against the 
disorders and dangers of the teething period he also advises rubbing the 
nape of the infant's neck, the shoulders, the back, and the lower limbs, 
always taking care, however, to rub from above downward, thus oflPering 
opposition to the flow of humors toward the upper parts of the body. 

These means and methods of treatment reflect, so to speak, the medical 
ideas and the curative practices of that time, and come down, in part, from 
remote ages, as evidently appears from what is said in diflFerent parts of 
this book. But such small blemishes ought certainly not to be taken into 
account in passing judgment on Bunon's works, the most substantial 
part of which is made up of very original ideas and observations. The 
high intrinsic value of Bunon's works gives him a just right to be con- 
sidered one of the most illustrious forerunners of modern scientific 

Bartolomeo Ruspini, an Italian dentist, exercised his profession in 
London with great success for more than thirty years. He was patronized 
by all the greatest personages of the Kingdom and also by the Royal 
family, from whom he received special marks of distinction. He attained 
a very conspicuous position, and with the aid of the London Freemasons' 
Lodge, of which he was an influential member, but chiefly by the results 
of his professional work, he was able to found an orphanage that was 
called by his name, being moved to do this by his great love for children, 
whose dental maladies and disorders had always been an object of par- 
ticular study for him. In 1768 he published A Treatise on the Teeth, 
Their Structure and Various Diseases. This book was remarkably well 
received and went through a number of editions, the last in the year 


1797. Ruspini did not, in reality, contribute very much to the develop- 
ment of dental science. He is, however, to be especially remembered as 
the inventor of a very good mouth mirror, a means of examination which 
afterward gradually came into general use. 

Having brought our history of dentistry up to the end of the eighteenth 
century, in order to complete our work we must now speak of an innova- 
tion in dental prosthesis, which, although gradually brought to perfection 
in the following century, was first introduced at that time. We allude to 


The merit of this invention is due, in part, to an individual outside 
the dental profession, namely, to the French chemist Duchateau, of St. 
Germain en Laye, near Paris, who first had the idea of employing porcelain 
as material for dental prosthesis. However, his idea would not have 
yielded fruitful results had it not been for the cooperation of the dentist 
Dubois de Chemant, who succeeded in putting it into practice. 

The circumstances connected with this invention were the following: 
The chemist Duchateau had for some time worn a denture of hippopota- 
mus ivory, but as usually happened with all the prosthetic pieces of that 
time, which were made of organic material, and were, therefore, subject 
to decay, this denture had acquired a very disagreeable odor, resulting 
from the action of the buccal humors. Besides which, Duchateau 
being obliged, by reason of his profession, to continually taste pharma- 
ceutic preparations, his denture had gradually become impregnated with 
medicinal substances that imparted a nauseous taste to everything he 
ate. The unpleasantness of this was a subject of much consideration 
with him, and thus it was that, to remedy the evil, he gradually matured 
the idea of having a porcelain denture made, on the model of the ivory 
one. In the year 1774 he applied to the porcelain manufactory of M. 
Guerhard in Paris for the carrying out of his design. The first trial 
was not successful, for in the baking the paste contracted so much that 
the denture was no longer of the right dimensions. To remedy this, he 
now had another and larger denture made, to allow for its contraction 
in the baking. But the results did not correspond with his wishes, and 
many trials were still necessary before Duchateau was able to obtain a 
denture which he judged fit for use, although not without defects. As 
this denture, because of its dead whiteness, produced an unpleasant 
effect, he had a yellowish tint, resembling that of the natural teeth, given 
to it, and, as is usual with painting on porcelain, fixed this color by baking 
a second time. 


However, this denture proving unserviceable, Duchateau was obliged 
to put it aside and begin new experiments. These were made with a 
special kind of porcelain paste used in France for the first time in 1740, 
which vitrified in baking at 12° to 25° by Wedgwood's pyrometer, whilst 
the usual porcelain required a temperature of 72° to 75° by the same 
test; but the results thus obtained were no better than the preceding 
ones, and upon these new failures Duchateau applied to the dentist 
Dubois de Chemant, of Paris, for his collaboration. Together they 
made fresh attempts, modifying the composition of the paste by adding 
a certain quantity of pipe clay and other coloring earths to it. These 
modifications enabled them to carry out the baking of the pieces at a 
much lower temperature, and after various experiments the final result 
was a denture that fitted the gums well enough, and which, in point of 
fact, Duchateau was able to wear. 

Encouraged by this success, he tried to manufacture like dentures for 
personages of high rank, hoping to gain money thereby, but his want of 
knowledge of the dental art prevented him from succeeding in his under- 
taking. However, in 1776 he laid this new process before the Royal 
Academy of Surgeons in Paris, receiving the thanks of that body as well 
as an honorable mention. 

Whilst Duchateau, discouraged by failure, was giving up all idea of 
deriving profit from the practical application of his invention, Dubois de 
Chemant, on the contrary, did not cease working for a moment, in order 
to bring the new method of prosthesis to perfection. Little by little he 
introduced important modifications into the composition of the mineral 
paste used in the manufacture of the dentures, incorporating therewith 
Fontainebleau sand, alicant soda, marl, red oxide of iron, and cobalt. 
His experiments and researches aimed at three principal ends, viz.: 

1. The obtaining of mineral teeth offering all the gradations of color 
presented by natural ones. 

2. The arriving at a rigorous calculation of the contraction of the mineral 
paste in the baking, so as to be able to make prosthetic pieces of the 
desired form and dimensions. 

3. The perfecting of the means of attachment of the prosthetic pieces, 
and, in particular, of the springs. 

By working with intelligence and perseverance, Dubois de Chemant 
gradually obtained satisfactory results, and when, in 1788, he published 
his first pamphlet on mineral teeth, he had already made dentures and 
partial prosthetic pieces for a certain number of persons, who wore them 
to great advantage. 

As to the chemist Duchateau, from 1776 to 1788, that is, during the 
twelve years subsequent to his communication to the Academy of Sur- 
geons, he did absolutely nothing at all. He is, therefore, entitled to the 


credit of having had a happy idea and of having endeavored to put it into 
practice; but the merit of having given life to the idea, abandoned for 
so many years by him with whom it originated, is exclusively due to 
Dubois de Chemant; he is, therefore, with reason considered the true 
inventor of mineral teeth. 

Dubois de Chemant, however, was so unjust as to take the whole 
credit of the invention for himself, declaring in his writings that the 
original idea had been exclusively his own, and was in no way due to 

In 1789 Dubois de Chemant made his invention known to the Academy 
of Sciences and to the Faculty of Medicine of Paris; both pronounced in 
favor of it, and in consequence of the opinion given by such high author- 
ities, he soon after obtained an inventor's patent from Louis XVI. 

Dubois' successes now aroused the envy of many of his colleagues, and 
especially of Dubois Foucou, the king's dentist, who, together with the 
greater part of the dentists of Paris and the chemist Duchateau, brought 
an action against him, accusing him of having usurped the invention 
of Duchateau, and demanding, for this reason, the annulment of the in- 
ventor's patent that had been granted him. But the law courts, in an 
opinion dated January 26, 1792, rejected the demand for annulment, 
recognized the patent of invention as fully valid, and condemned Dubois 
Foucou, Duchateau, and their confederates to the costs of the judgment. 

Paris being at that time in full revolution, Dubois de Chemant was 
induced to emigrate to England. He established himself in London, and 
there obtained a patent without much difficulty, according him the 
exclusive right, for fourteen years, of manufacturing dentures of mineral 

Dubois de Chemant wrote several pamphlets in order to make known 
to the public this new kind of dental prosthesis and its advantages; some 
of these were published in Paris (1788, 1790, 1824), and others during his 
long residence in London, where he remained from 1792 to 18 17. In 
these pamphlets he upholds the great superiority of "the incorruptible 
teeth of mineral paste" over all other kinds of artificial teeth; he calls 
special attention to the fact that teeth of bone, ivory, and of every other 
organic substance whatever gradually become spoilt through the action of 
the saliva, of oral heat, of food and drink, etc., and not only lose their 
primitive color and assume a dirty hue, most unpleasant to the eye, but 
acquire a bad odor, at times quite insupportable, becoming, besides, a 
cause of irritation to the gums and the mucous membrane of the mouth, 
not to speak of their gradual softening and wearing out, which renders 
them unserviceable after a certain time. All these disadvantages were 
avoided by using the new prosthetic material, this being incorruptible 
and inalterable. 


The prosthetic appliances by Dubois de Chemant were made in one 
single piece that represented the gums and teeth, whether in the case of 
one or more teeth, or of whole dental sets. He used to take a cast of the 
parts on which the prosthesis was to be applied, and by a process, the 
details of which are not known; he succeeded in obtaining prosthetic 
pieces that fitted the parts perfectly, notwithstanding the difficulties re- 
sulting from the shrinking of the paste in baking. If the piece required 
retouching, he did this by means of special tools for grinding down por- 
celain. He could, besides, drill holes in the porcelain for the application 
of the means of attachment. In fact, Dubois de Chemant was the 
creator of a new method of prosthesis applicable to any and every case, 
and which gained the praise and admiration of the great doctors and 
scientists of that day, among whom may be mentioned GeofFroy, Vicq 
d'Asyr, Descemet, Bajet, Petit Radel, Darcet, Sabatier, Jenner, and 
others. The Paris Faculty of Medicine gave it as their judgment that 
the prosthetic pieces manufactured by Dubois de Chemant united the 
qualities of beauty, solidity, and comfort to the exigencies of hygiene. 

These eulogies must, however, be received with a certain reserve, as, 
beyond doubt, the mineral teeth of that time still left much to be desired. 
In England, where, as we have already said, they had been introduced by 
the inventor, they at first obtained a great success, which was, however, 
of short duration, and Maury^ tells us that toward 1814 they had fallen 
into great discredit and had been entirely abandoned; this signifies that 
practically they did not fulfil the expectations held out. 

Dubois Foucou and Fonzi. Among the first who occupied themselves 
with the manufacturing of mineral teeth, contributing also to their 
improvement, are to be named Dubois Foucou, to whom we have already 
made reference, and Fonzi, an Italian by birth, who exercised the profes- 
sion of dentist in Paris. Dubois Foucou made some improvements in 
the coloring of porcelain teeth, and in 1808 published a pamphlet in 
which he explained his mode of proceeding in manufacturing them.' 
In the same year Fonzi made known a new kind of teeth,' which he 
called terro'tnetallic. These differed from those of Dubois de Chemant 
in that they were all single teeth intended to be applied on a base bv 
means of small hooks of platina, with which each tooth was furnished. 
In addition to this important innovation, Fonzi also discovered the 
means of imitating in some degree the semitransparent tint peculiar to 
natural teeth. 

^ F. Maury. Traite complet de I'art du dentiste, d'apres I'etat actuel des connaissances, 
2 vols., Paris, 1828. 

' Expose de nouveaux procedes pour la confection des dents dites de composition, par 
M. Dubois Faucou, Paris, 1808. 

' Rapport sur les dents artificielles terro-metalliques, Paris, 1808. 



Notwithstanding this, the teeth made by Fonzi, of which there are still 
some specimens in various dental nnuseums, had anything but a good 
appearance, and there still remained much to be done before mineral 
teeth reached the height of perfection which they attained later on. 

The credit of having introduced many new improvements in the manu- 
facture of mineral teeth belongs especially to the Americans. Among 
those who particularly distinguished themselves in this department of 
dental art, we may note Charles W. Peale. Samuel W. Stockton, James 
Alcock, and Dr. FAias Wildman. But the most brilliant results, as is 




well known, were obtained by the celebrated Samuel S. White, who, by I 
an intelligent and persevering activity, dedicated almost exclusively to ' 
improving mineral teeth and to bringing them into general use, con- 
tributed vastly to the progress of modern dental art, Samuel S. White 
undoubtedly stands forth as one of the noblest and grandest figures in 
the history of dentistry, and his name will ever be recorded with honor 
and veneration by dentists of all ages. 


Abbott, A. C, 237 

Abulcasis, 86, 125 

Abyssinia, negroes of, file incisors into points, 

Acoluthus, Johann, 240 

Acupuncture, 38 

Adamantius, 116, 117 

Advertisements, 245 

iEgina, Paul of, 219 

iEsculapius, 45, 46 

iEtiusof Amida, 117, 170 

Age of animals judged by the teeth, Aristotle 

on, 62 
Aitkin, John, 317 
Alcock, James, 348 
Ali Abbas, 122 

Altomare, Donato Antonio, 200 
Alveolar pyorrhea, 06, 237 
Andromachus the Elder, 106, 1 13 
Andry, 269, 309 
Anesthetic, 14^ 
Antrum of Highmore, 186, 233, 249, 250, 

257, 282, 304, 310, 311, 313, 318, 320, 

325, 330» 333 
Aphthae, Celsus on, 84 

Apollonius, 02, 113 

Appolonia, oaint, 20^ 

Aquapendente, Fabnzio of, 207 

Arabians, 121 

Aranzio Giulio Cesare, 201 

Arca^atus, 77 

Archi^enes, 65, 106, 113 

Arcoh, Giovanni of (Arculanus), 153, 168, 

Argelata, Pietro of, 151 
Aristotle, 53, 61, 64 
Arnemann, J., 331 

Arsenic, 35, 85, 122, 125, 138, 152, 157 
Asclepiades, 80 
Asklepiadi, priests of the temple of iEscula- 

pius, 45, 46 
Astringent mouth washes, 97, 115, 116, 122, 

'53 . 
Atmospheric conditions, influence on dental 

maladies, 57, 116, 247 

Aurelianus, Celius, 46, 65, 113, 114 

Auzeki, Pierre, 317 

Avenzoar, 139 

Avicenna, 84, 123 


Babylonians, treatment of sick by the, 18 
Bacteria, 2^7 

Barbers, 86, 130, 132, 139, 144, 159, 162, 
166, 169, 188, 240, 242, 243, 244, 245, 

255 ^ 
Barden, A., 340 

Bartholin, Thomas, 232, 235 

Bass, Heinrich, 259 

Bell, Benjamin, 324 

Belzoni, G. B., on Egyptian dentistry, 27 

Benedetti, Alessandro, 157, 187 

Benedictus of Faenza, 203 

Berdmore, Thomas, 315, 316 

Bertin, J., 304 

Bible, reference to teeth in the, 32, 33 

Bidloo, Gottfried, 239 

Birds, teeth of, 63 

Blum, Michael, 164 

Blumenthal, K. A., 337 

Bodenstein, Adam, 205 

Bordenare, Thomas, 313 

Bourdet, 309 

Brahmins, care of the teeth among the, 42 

Bridgework, 297 

Etruscan attempts at, 76, loi 

Bromfield, W., 318 

Brunner, Adam Anton, 315 

Bruno of Longobucco, 140 

Bruschi, Etruscan dental appliances in 

Museum of Count, 73 

Biicking, 321 

Bunon, Robert, 301, 337 

"Calendar of dentition," 315 
Callisen, Heinrich, ^^^ 
Camindus, Balthasar, 215 
Campani, Antonio, 323, 327 
Capivacci, Gerolamo, 201 
Carabelli, 157,317,321 
Carbonate of time, ancient dentifrice men- 
tioned by Pliny, 94 
Caries, dental, 24, no, 122, 147, 251, 269, 

319* 335 
Carmeline, 253, 261, 283 

Cascellius, first dentist mentioned by name, 




Castellani collection, Rome, Etruscan appli- 
ances in, 76 

Catullus, 97 

Cauteries, dental, 328 

Cauterization, 25, 40, 85, 107, iii, 118, 126, 
138, 152, 212, 227, 246, 289, 310 

Caylus, 99 

Celius Aurelianus, 46, 65, 113 

Celsus, 65, 80, 83, 84, 85, 86, 87, 102 

"Cement" filling, 122, 240 
of Guillemeau, 253 

Channing, John, 126 

Charlatans, 159, 162, 277, 310, 316 

Chauliac, Guy de, 146 

Chemant, Nicholas Dubois de, 329, 344 

Chinese, anatomical notions of, 39 
dentistry among the, 34 

Chopart, 322 

Cigrand, 47, 68, 316 

Cintio d'Amato, 242 

Clasps, 30^ 

Clauder, Gabriel, 232 

Cleanliness of the teeth among the Romans, 
97, 106, 107 

Coiter, Volcherus, 200 

Coition, toothache from, 3^ 


to the teeth. 

Cold applications, harm! 


Colombo, Matteo Realdo, 177 
Come, Frere, 318 
Compressor of Foucou, 321 
Condamine, 314 
Cometo, museum of, Etruscan appliances 

in, 71, 72, 73 
Cos, temple of, medical records in, 18, 46, 48 
Courtois, 321 
Cowper, William, 234, 249 
Cremation among the ancients, 69 
Criton, 113 

Croce, Giovanni Andrea della, 201 
Cron, Ludwig, 255 

Crowley's "Dental Bibliography," 253, 256 
Crown, artificial, 296, 315 

gold, 217, 303 
Ctesias of Cydnus, 62 
Customs of primitive peoples, 42 

Dabry, p. p., "Les medecine chez les 

Chinois," 34 
Dalli Osso, archeologist, 78 
Damocrates, Servilius, 106 
Daremberg, "Histoire des sciences medi- 

cales," 80, 99 
De Lavauguyon, 253, 255 
Decorative medicine, 244 
Dekkers, Friederich, 241 
Delphi, temple of Apollo at, 46, 114 
Deneffe, "La prothese dentaire dans I'anti- 

quite," 67, 75, 102 

Dental appliance, Etruscan, found at Tar- 

quinii, 71 
near Teano, Italy, 79 
at Valsiarosa, 70 
art among the ancient Germans, 162 
the Etruscans, 67 
the Romans, 77, 102 
first beginnings of, 17 
practised by specialists in ancient 

. Egypt, 25 

canes, no, 122, 147, 251, 269, 319 

irregularities, 280, 200, 303, 320 

maladies given in Eoers' papyrus, 21 

surgery not mentioned in fibers' papy- 
rus, 25 

and surgical instruments of the Romans, 

terminology found in Vesalius, 1 76 
Dentateurs, 199 
Dentator, 144, 147 
Dentiduces, 226 
Dentifrices, 35, 38,^1, 87, 93, 94, 96, 97, 105, 

112, 124, 141, 148, 154, 247, 322 
Dentine, structure of, 237, 319 
Dentisculpia (toothpicks), 98, 226 
Dentispices, 219 
Dentist, the word itself, 102, 144 

Cascellius the first, 102 
Dentista, 144 
Dentistry, condition of, before Fauchard, 260 

in the middle aees, 121 

as a true specialty, 255, 263 
Dentists, examination of, 261, 339 
Dentition, "Calendar" of, 315 

third, 91, 143, 185, 199, 306 
Dentures, complete, 298, 313, 336 

porcelain, 344 

spring, 299, 300 
Deodato, Claudio, 224 
Desault, 322 

Deschapellement (uncrowning), 194,204,275 
Diemerbroek, 235 
Diest, Jean de, 301 
Dionis, Pierre, 251 
Dioscorides, 84 

Dissection prohibited by the Koran, 121 
Doctors* shops in ancient Greece and 

Rome, 52 
Drake, James, 249 
Dubois de Chemant, Nicholas, 329, 344 

Foucou, 346, 347 

Jacques, 172 
Duchateau, 344 

Duchemin, student of Fauchard, 260 
Dufour, 309 
Dupont, 223 
Duvemey, Jean, 238 

Ears and the teeth, 54, 56, 94, 228, 236, 250, 



Ebers' papyrus, 19 

George, on dental art of Egyptians, 28 
Egypt, special doctors for the teeth in ancient, 

Egyptians, dental art among the, 19, 67 

prescriptions of the, 21, 22, 23, 24 
Eighteenth century, 255 
Electricity, use of, for toothache, 314 
Elevator of Lecluse, 305 

Elevators, I33».i34,305 
Enamel, artificial use of, 301, 310 

structure of dental, 238 
Endelman, Julio, 205 
English key, 257,317 
Epilepsy, 169 

Epulis, 117, 118, 123, 127, 239, 251, 334 
Erasistratus, 6^ 

Erosion, dental, 302, 320, 337,^41 
Etruscans, dental appliances of^ 70, 7I9 72, 73, 

74, 76 
art among the, 67, 70 

votive offerings of, 67 

Eustachius, Bartholomeus, 178, 204 

Examination of dentists, 261, 339 

"Experts pour les dents," 261 

Extraction of teeth, 25, 45, 51, 64, 82, 86, 
103, 108, 112, 114, 118, 122, 124, 128, 
137, 141, 151, 152, 158, 160, 193, 
210, 222, 240, 246, 252, 276, 292, 

3i5» 321, 337 
death from, 65, 114, 137, 139 

of eye-teeth, 301,339 

pain after, 112 

as a punishment, 139 

Eyes and the teeth, 54, 89, 168, 246, 301, 304 

Fabrizio of Aquapendente (Fabricius), 207 

Fabry, Wilhelm (Fabricius Hildanus), 223 

Fallopius, Gabriel, 177 

Faucnard, Pierre, 255, 259 

Filing of teeth by people of India, 42 

by women of^Sumatra, 43 
Filling of teeth, 122, 147, 150, 151, 155, 159, 
164, 199, 208, 240, 252, 256, 285, 309, 
Fingers, extraction of teeth with the, 64 
Fischer, Johann Bernhardt, 259 
Fistulae, dental, 22, 140, 152, 201, 203, 224 
Fleurimond, 245 
Follicle, dental, 177 

Fontanella, Don Angelo, anecdote of, 104 
Fonzi, 347 
Forceps, cutting, 294 

extracring, 46, 52, 86, 87, 114, 131, 157, 
167, 207, 211, 226, 278, 292, 293, 

3^5, 330, 334 
Foreest, Peter, 1^7, 202 

Foucou, 3i«, 34^.347 

Fractureof lower jaw, 59, 137, 190, 342 

Fractures and dislocations, Celsus on, 87 
Fredericus, Rinaldus, 235 
Frogs, use of, for dental maladies, 95, 107, 
125, 138 

Gaddesden, John, 140 

Gagliardi, Domenico, 238 

Gaillardot, Dr., researches in necropolis of 

Sidon, 29 
Galen, Claudius, 52, 63, 65, 80, 82, 108, 109, 

Garengeot, Croissant de, 257 
Gebauer, Ernst Ferdinand, 259 
Geist-Jacobi, 23, 59, 78, 102, 114, 157, 163, 

166, 169,220,306,311,314 
Genga, Bernardo, 235 
Gerauldy, Fr. A., 302, 338 
Gerbi, Ranieri, 332 
''German key," 257 
Germans, dentistry among the, 161 
Ghent, University of, Etruscan appliance in 

museum of, 74 
Gilles, Arnauld, 222 
Gingivitis, treatment of, by Galen, 1 1 1 
Giovanni of Arcoli, 153, 168, 199 

of Vigo, 159 
Glaubrecht, F. E., 314 
Gold appliances of the Etruscans, 71 
of the Romans, loi 

bands, mentioned in law of the Twelve 
Tables, 77 

crown, 217,303 

fillings, 29, 156, 159, 164, 208, 252, 

teeth, substitution of, in Java, 42 
in Macassar, 43 

wire, use of, 30, 87, 135, 146 
Golden tooth, story of the, 214 
Goritz, Johann Adolph, 258 
Gout, 219 

Grabner, C. A., 315 
Grafenberg, Johann Schenck von, 202 
Greek doctors in Rome, 79 
Greeks, ancient appliance of the, 60 

dentistry among the ancient, 45, 77 
Griffon, J., 225 
Guerhard, 344 
Guillemeau, Jacques, 253 
Gums, diseases of, according to Celsus, 84 
Guy de Chauliac, 142 

Haller, Albert von, 166 

Harris, Walter, 239 

Havers, Gopton, 239 

Hebrews, dental affections rare among the 

ancient, 32 
Hcckcr, A.T., 331 



Heister, Lorenz, 255 

Hemard, Urbain, 194, 203 

Hemorrhage after extraction, 229, 231 » 258, 

30«» 30^32^335 
of the gums, 115, 157 

Henkel, 318 

Heraclides of Tarentum, 65, 113 

Herodotus, 18, 25, 64 

Herophilus, 65 

Heurmann, Georg, 305 

Heurn, Johann (Heurnius), 175, 212 

Hieratic characters, Ebers' papyrus in, 20 

Highmore, Nathaniel, 186, 232 

Hindostan, care of the teeth by the natives 

of, 42 
Hindu dentists, primitive type of dental 

prosthesis by, 30 
Hippias, anecdote from Herodotus on, 26 
Hippocrates, 17, 18, 47, 108 
Hirsch, Friedrich, 334 
Histology, 236 
Hoffmann, Johann, 249 
Homer, refers to sons of v^sculapius, 45 
Horace, false teeth mentioned in satire of, 102 
Horst, Jacob, 214 
Houllier, Jacques, 199 
Hunter, John, 316, 318, 324 
Hurlock, Joseph, 303 
Hygiene of the mouth, 80, 87, 92, 106, 107, 

127, 144, 153, 196, 230, 248, 266, 310, 330, 

Hypoplasia, dental, 341 

Immunity from toothache, 221 

Implantation, 311 

India, people of, customs relating to the 

teeth of, 42 
Ingolstetter, Johann, 215 
Ingrassia, Gian Filippo, 177 
Instruments, 52, 128, 144, 151, 157, 167, 192, 
201, 2oi5, 207, 211, 226, 227, 241, 279, 

284, 33^ 

for extractmg, 321, 323, 327 

of gold, 251 

of tne Romans, 86 
Iron, tooth of, 232 
Irregularities, dental, 280, 290, 303, 320, 342 

Key with changeable hooks, 326 
English, 257, 317 
of Garengeot, 257 
Kircher, 217 
Kirk, E. C, 28, 30, 43, 82, 83, 84, 96, 115, 

118, 138, 164,216,307,308 
Klaerich, F. W., 314 
Knights of the Teutonic Order, 163 
Koran, dissection prohibited by the, 121 

Jacobaens, Oligerus, 231 

Java, substitution of gold teeth by people of, 

^^ . . . 

Joachim, Heinrich, translation of Ebers' 

papyrus by, 19 

Jourdain, 311 
unker, Johann, 257 

Lancets, gum, 195 

Lancing of the gums, 198, 239, 257, 265, 

303* 304. 312, 321, 322, 324, 331, 334, 336 
Lanfranchi, 140 
Lavini, 301 

Law of the Twelve Tables, 69, 77, 78 
Le Hire, 265 

Lead for filling teeth, 285, 309, 320, 335 
Lecluse, 257, 305 
Leeuwenhoek, Antoni van, 237 
Lemerle, 317 
Lemorier, 313 
Lentin, L. B., 314 
Lentisk wood, toothpicks of, 08 
Lepsius, opinion of, on Ebers papyrus, 20 
Lettson, 329 
Leucorrhea, 58 
Leyden, Lucus van, 213 
Liddel, Duncan, 216 
Ligatures, Abulcasis on, 135 
Linderer, Joseph, 27, 42, 98, 139, 162, 181, 

220, 257, 313 
Loder, 257 
Longevity, influence of number of teeth on, 

Lusitanus, Amatus, 229 
Luxations of jaw, 88 


Magnet, use of, for toothache, 314 
Major, Daniel, 240 
Malpighi, Marcello, 236 
Manteville, 269 
Marcellus, 115 
Martial, epigrams of, 98 
Martin, Benjamin, 241 
Martinez, Francisco, 205 
Massage, ancient practice of, 114 
Massez, 313 

Maxillary sinus, 186, 233, 249, 250, 257, 
282, 304, 310, 311, 313, 318, 320, 325, 330, 

333 , , 

Mechanical dentistry, first work on, 303 

Medicine in ancient Eygpt, 19 

decorative, 244 



Medicine, most ancient work on, 19 

sacerdotal, 17 

special branches of, 103 
Meibom, Heinrich, 250 
Mercury, harmful effects of, 158, 202, 230 
Mesue the younger, 137, 164 
Mice, use of, for dental maladies, 36, 50, 93, 

94, 97 
Microorganisms, 237 

Microscopes, 236, 237, 260 

Middle ages, dentistry in tne, 121 

Minadous, Thomas, 232 

Mineral teeth, 2^4, 329, 344, 348 

waters of Carlsbad, 220 
Models in dental prosthesis, 241, 306 
Modem times, dentistry of, 161 
Molinetti, Antonio, 234 
Monavius, Petrus, 205 
Monkey, dental system of, 63 
Montagnana, Bartolomeo, 152 
Montanus, Giovanni Battista, 230 
Moraine's verses on Fauchard, 260 
Motte, G. M. de la, 258 
Mouth mirror, 344 

washes, 55, 97, in, 265, 274 
Mouton, 303, 300 
"Moxa," use of, by Chinese, 40 
Mummery, J. R., 25, 29 
Mummies, Egyptian, 27, 28, 49 
Murphy, Josepn, 42 
Museum of antiquities, Dresden, 162 

iarcheological) of Athens, 52 
archeological) of Florence, 70 
of Cometo, 71, 72, 73 
of Count Bruschi, 73 
of Pope Julius, Rome, 70, loi 
of University of Ghent, 74 
Musitano, Carlo, 247 


' Odontalgia, 34, 38, 51, 92, 95, 103, 106, 107, 
! 109, III, 113, 124, 137, 141, 145, 150, 152, 
I 154, 158, 190, 202, 219, 220, 221, 228, 247. 
248, 271, 283, 314, 332 

Odontitis, 331 

Operative dentistry, Fauchard on, 284 

Oribasius, 117 

Orvieto, 69, 74 

Nasal prosthesis, 256 
Necrosis of lower jaw, 241 

of the teeth, 56 
Nerves of teeth, 109 
Neuralgia, 224 
Nicaise, £., 142 
Nobile, Luigi, 78 
Nomenclature, 88, 318 
Nuck, Anton, 245 
Number of teeth, 59, 109 

Obturators, 197, 198, 211, 301, 310 
Oceanica, dyeing the teeth black by races of, 

Odontagogon, 46, 65, 114 
Odontagra, 64 


I Papyrus of Ebers, 19 
Paracelsus, 176 
Pare, Ambroise, 188 
Pasch, J. G., 314, 315 
"Pastophori" treatment of sick by, 19 
Paul ot iEgina, 118 
Peale, Charles W., 348 
Pechlin, Nicolaus, 232 

Pelican (extracting instrument), 157, 158, 
167, 193, 206, 211, 226, 281, 290, 291, 292, 

3M» 323, 324, 330» 334 
Perine, Geo. H., 27 

Periodontitis, 122, 320 

Petronius, 98 

Peyronie, de la, 339 

PfafF, Philip, 305 

Pfolsprundt, Heinrich von, 163 

Phoenicia, ancient dental appliance found 

at Sidon, 29 

influence of, on Etruscan dentistry, 67 
Phoenician vase, with portrayal of dental 

operation, 47 
Pietro of Albano, 144 

of Argelata, 151 
Pig, teeth of the, 62 
Pincers, ligature, 295 
Plaster models, 306 
Plateario, Giovanni, 152 
Pliny, 89, 102 
Pluggers, 288 
Pomaret, Denis, 223 
Portal, 245 

Poteleret, Alexandre, 262 
Pregnancy, extraction of teeth during, 301, 

339. . 
Prescriptions, Chinese, 35 

dental, of Hippocrates, 50 

Egyptian, 20, 21, 22, 23, 24 

Priesthood, ancient, treatment of sick by, 17 

Primitive peoples, customs relating to teeth 

of, 42 
Prosthesis, dental, 146, 21 1, 296 
Prosthetic pieces, movable, 256 
Pulp-capping, 306 
Pulp, inflammation of, recognized by Archi- 

genes, 107 
Pumice stone in dentifrices, 96, 97, 141, 203 
Purland,T., 28 

Purmann, Matthias Gottfried, 241 
Pyorrhea (alveolar), 96, 237 



[UACKS, 159, 162, 277, 310 

\m\\ toothpicks mentioned by Martial, 98 

Ranula, Abulcasis on the cure of, 137 

Renan, "Mission de Phenicie,** 29 

Replantation, 136, 191, 251, 281, 293, 305, 

^309> 316, 321, 334, 335 

Rhazes, 84, 121, 122, 153 

Riccio, Tommaso Antonio, 242 

Richter, A. G., 329 

Riviere Lazare (Riverius), 228 

Rizagra (Greek forceps), 87 

Romans, dental art among the, 77 

Rome, Arcagatus the first Greek doctor in, 77 

RuefF, 316 

Ruland Martin, 215 

Runge, L. H., 304 

Ruspini, Bartholomeo, 343 

Russel, 313 

Ruysch, Friederich, 236 

Ryfr, Walter, 157, 161, 166 

Silesian child, golden tooth of the, 214 
Silver, toothpicks of, mentioned in satire of 

Petronius, 98 
Six, Martin, 231 

Sixteenth century, dentistry in the, 161 
Spiegel, Adrian (Spigelius), 235 
Sprengel, "Geschichte der Chirurgie," 139, 

166, 223, 2«, 257, 259, 304, 337 
Sternberg, J. H., 337 
Stockton, Samuel W., 348 
Story of the Golden Tooth, 214 
Strabo, 98 

Strobelberger, Johann Stephan, 218 
St. Yves, Charles, 250 
Surgeon-dentist, 244, 339 
Surgery, ancient, eminently conservative, 108 
Surgical instruments deposited in the temples, 


Sylvius, 172 

Saalburg, forceps found in ancient castle of. 

Saliva, 331 

Salmuth, Philip, 232 

Sandwich Islands, natives of, sacrifice front 

teeth, 43 
Satricum, example of gold crown work found 

at, loi 
Saws, dental, used by Abulcasis, 136 
Scalers, Abulcasis on use of, 127 
of Fauchard, 285 

of silver mentioned by Fabricius, 210 
SchafFer, Jacob Christian, 306 
Schelhammer, Christopher, 250 
Schmidt, Prof. Emil, 29 
Schultes, Johann (Scultetus), 226 
Schuiz, Gottfried, 232 
Scorbutus, case of, mentioned by Hippocrates, 

Scribonius Largus, 103 

Scultetus, 226 

Scurvy, 57, 237 

Secrecy among dentists, 262 

Senile decay, 186, 238 

Serapion, 123 

Serre, 47, 78, 330 

Serres, 181, 217 

Seventeenth century, dentistry in the, 218 

Severino, Marco Aurelio, 227 

Shops of doctors in ancient Greece and 

Rome, 52 

Sidon, necropolis of, 29 

Tagliacozzi, Gaspare, 226 

Talmud, the, 32 

Tartar, dental, 119, 127, 150, 151, 237, 244, 

Teano, Italy, prosthetic piece found near, 78 
Teeth, artificial, Dionis on, 252 
of the Etruscans, 70 
mentioned by Martial, 100 
opposition to use of, 241, 258 
Pare on, 197, 
Romans, 78 
care of the. See Hygiene of the mouth, 
among the Brahmans, 42 
the Romans, 97 
dignity and importance of the, 235 
dyeing black, by married women of 
Japan, 43 
by races of Asia and Oceanica, 

red, by people of eastern India and 
Macassar, 43 
gilding of the, in Sumatra, 43 
of mummies, 28, 29, 49 
names of, as given by Guy de Chauliac, 

number of, indicated by Galen, 109 
influence on long life of, 58 

pivot, no evidence of Egyptian knowl- 
edge of, 29 

Pliny on persons born with, 89 

trepanning of, advised by Archigenes, 65 
Terminology, dental, found in Vesalius, 176 
Teske, J. G., 314 
Theodorico Borgognoni, 140 
Theriac, famous remedy of Andromachus, 

Tin for filling teeth, 285, 329, 335 
Tobacco, 220, 230 
Tonsillitis, Celsus on, 83 
Tooth brushes, 266, 334 



Tooth of iron, 232 

story of the golden, 214 
Toothache, 35, 51, 80, 92, 103, 106, 107, 109, 
113, 115, 126, 150, 190, 202 
immunity from, 221 
Toothpick and ear-picker of gold found in 

Crimea, 99 
Toothpicks, 94, 98, 208 
Transplantation, 282, 293, 303, 321, 329, 

334, 335 
Treatment of dental disorders by the Chinese, 

Trephine, use of, by Archigenes, 108 
Trueman, Wm. H., 68 
Tulp, Nicolaus, 231 


Uncrowning of teeth, 194, 204, 275 
Urine, 35, 43, 97, 98, 274 
Uxedu, painful swelling, referred to in Ebers' 
papyrus, 20, 23 

Valentini, Bernardo, 234 

Valescus of Taranta, 149 

Valsiarosa, dental appliance found at, 70, 72 

Van Leeuwenhoek, Antonie, 237 

Van Marter, J. G., 27 

Van Meekren, Hiob, 239 

Van Soolingen, Kornelis, 240 
Van Wy, J., 322 
Vasse, David, 301 
Verduc, Jean, 253 
Vesalius, Andreas, 172 
Vigo, Giovanni of, 159 
Virchow, 29 

Votive offerings, dental, of Etruscans, 68 
tables in ancient temples, 18, 46 


Weapons, teeth of animals as, 62 

Wecker, Johann Jacob, 200 

Westphal, A., 304 

Weyland, Fr. L., 318 

White, Samuel S., 348 

Wichmann, J. E., 336 

Wildman, Elias, 348 

Wilkinson, Sir Gardner, 28 

Willich, 321 

WoofFendale, Robert, 316 

Worms, dental, 104, 125, 126, 141, 148, 150, 

I53» 158, I99» 203, 214, 220, 228, 229, 
231, 232, 247, 268, 307, 309 
Wurfbein, Paul, 241 

Znamenski, 295 
Zwinger, Theodor, 240 


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